United States District Court, S.D. Indiana, Indianapolis Division
ENTRY ON MOTION FOR ADMINISTRATIVE REMAND AND MOTION
WALTON PRATT, JUDGE
the Court is a Motion for Administrative Remand and to Stay
Proceedings filed by Defendants Hartford Life and Accident
Insurance Co. (“Hartford”) and Springleaf
Finance, Inc. Disability Plan (“the Plan”)
(collectively, “Defendants”) (Filing No.
25), as well as a Motion to Strike filed by Plaintiff
Dee Ann Miller (“Miller”) (Filing No.
30). On January 1, 2016, after exhausting all remedies
through the administrative process, Miller filed a wrongful
denial of employee benefits claim against Defendants pursuant
to the Employee Retirement Income Security Act of 1974
(“ERISA”), 29 U.S.C. § 1001 et
seq., (Filing No. 1). Defendants seek an
administrative remand, arguing Miller did not receive a
“full and fair review” because
“critical” evidence that benefits Miller was not
included in the administrative record. For the following
reasons, Defendants' Motion for Administrative Remand and
to Stay Proceedings is GRANTED and Miller's Motion to
Strike is DENIED.
worked for Springleaf Finance, Inc.
(“Springleaf”) from December 1999 until March 5,
2014. After nearly fifteen years, Miller stopped working at
Springleaf due to symptoms of severe fibromyalgia, psoriatic
arthritis, osteoarthritis, and chronic pain. Miller then
applied for short term disability (“STD”)
benefits provided through her employee benefit plan and
administered by Hartford. Hartford approved Miller's
application for STD benefits. After Miller received the
maximum duration of STD benefits, she applied for long term
disability (“LTD”) benefits under the terms of
her disability policy. On September 8, 2014, Hartford
approved Miller's LTD benefits claim. (Filing No.
27-1 at 2.)
Hartford received notice that Miller applied for Social
Security disability benefits, however, the Social Security
Administration denied Miller's claim on November 21,
2014, and denied her request for reconsideration on February
10, 2015. (Filing No. 29-4.) In April 2015, Hartford
consulted Ibraham Alghafeer, M.D., a rheumatology specialist,
and Marcus Goldman, M.D., a psychiatrist, both of whom opined
that Miller maintained the capacity to continue working.
(Filing No. 29-5 at 2-7.) The following month, on
May 7, 2015, Hartford sent a letter to Miller terminating
Miller's benefits as of April 30, 2015, explaining that
Miller failed to satisfy the Plan's definition of
“disability.” (See Filing No. 29-1
at 34, defining disability).
appealed the denial of benefits on October 28, 2015, and
submitted a 258-page appeal packet, including an appeal
letter and a three-page statement (“Physician's
Statement”) drafted by Miller's treating physician,
Dr. Judi Brezausek. (Filing No. 27-1.) Miller's
appeal letter referenced specific contents of the
Physician's Statement; however, due to a scanning error
by outside vendor Xerox Services Healthcare
(“Xerox”), the first two pages of the
Physician's Statement were not contained in the
administrative record. (Filing No. 27-2.) On
December 17, 2015, Defendants denied Miller's appeal
without knowledge of the missing pages of the Physician's
on January 20, 2016, Miller sought relief in this Court.
Miller filed a Complaint against Defendants asserting
wrongful denial of employee benefits. (Filing No.
1.) On July 26, 2016, during mediation and well after
the denial of Miller's appeal, Miller's counsel
informed Defendants that the first two pages of the
Physician's Statement were missing from the
administrative record. Miller represented that the two pages
of the Physician's Statement contain critical information
regarding Miller's medical condition and capacity to
work. On October 14, 2016, Defendants filed a Motion for
Administrative Remand and to Stay Proceedings in order to
evaluate the Physician's Statement and to provide Miller
with a “full and fair” review. (Filing No.
as in this case, a plan grants discretionary authority to the
plan administrator, a court reviews the denial of benefits
under the arbitrary and capricious standard. Hackett v.
Xerox Corp. Long-Term Disability Income Plan, 315 F.3d
771, 773 (7th Cir. 2003) (citing Hess v. Hartford Life
& Accident Ins. Co., 274 F.3d 456, 461 (7th
Cir.2001)). If a court determines that a plan administrator
acted arbitrary and capricious, the court must next determine
the appropriate remedy. Hackett, 315 F.3d at 775.
requires every employee benefit plan to
“afford…a full and fair review” of claim
denials. 29 U.S.C.A. § 1133. Generally, in ERISA cases,
if an administrator “fails to make adequate
findings” or “fails to provide… adequate
reasoning” for denial of benefits, the proper remedy is
to remand. Love v. Nat'l City Corp. Welfare Benefits
Plan, 574 F.3d 392, 398 (7th Cir. 2009); Majeski v.
Metro. Life Ins. Co., 590 F.3d 478, 484 (7th Cir. 2009);
Leger v. Tribune Co. Long Term Disability Ben. Plan,
557 F.3d 823, 835 (7th Cir. 2009). However, in rare cases, a
court may retroactively reinstate a claimant's benefits
where it is clear from the record that “the only
determination the plan administrator could reasonably make is
that the claimant is disabled.” Majeski, 590
F.3d at 484; Love, 574 F.3d at 398.
Motion to Strike
initial matter, Miller asks the Court to strike certain
exhibits filed by Defendants in their Reply brief. Federal
Rule of Civil Procedure 12(f) allows the court to
“strike from a pleading an insufficient defense or
redundant, immaterial, impertinent, or scandalous
matter.” Fed.R.Civ.P. 12(f). The court may, (1) act on
its own, or (2) on a motion made by a party either before
responding to the pleading or, if a response is not allowed,
within 21 days after being served with the pleading.
Id. Motions to strike are generally disfavored;
however, “where . . . motions to strike remove
unnecessary clutter from the case, they serve to expedite,
not delay.” Heller Fin., Inc. v. Midwhey Powder
Co., Inc., 883 F.2d 1286, 1294 (7th Cir. 1989).
November 22, 2016, in reply to Miller's Response in
Opposition to Defendants' request for remand, Defendants
designated six exhibits-Exhibits A through F. (See Filing
No. 29.) Without any substantive detail, Miller moves
the Court to strike pages six through eight of
Defendants' Reply brief, as well as corresponding
Exhibits B through E, arguing Defendants failed to raise the
issues contained in those exhibits in their initial brief.