Opinion
Civil No. 1:19-cv-00096-PLR-CHS
02-25-2020
Lori OLAH, Plaintiff, v. UNUM LIFE INSURANCE COMPANY OF AMERICA, and Unum Group Corp., Defendants.
Hudson T. Ellis, Eric Buchanan & Associates, PLLC, Chattanooga, TN, for Plaintiff. Ian C. Quillen, Pro Hac Vice, James T. Williams, IV, Jenna W. Fullerton, Michael James Dumitru, Miller & Martin, PLLC, Chattanooga, TN, for Defendants.
Hudson T. Ellis, Eric Buchanan & Associates, PLLC, Chattanooga, TN, for Plaintiff.
Ian C. Quillen, Pro Hac Vice, James T. Williams, IV, Jenna W. Fullerton, Michael James Dumitru, Miller & Martin, PLLC, Chattanooga, TN, for Defendants.
MEMORANDUM ORDER
Christopher H. Steger, UNITED STATES MAGISTRATE JUDGE I. Introduction
In this action, Plaintiff seeks review under the Employee Retirement Income Security Act ("ERISA") of 1974, 29 U.S.C. § 1132(a)(1)(B), of the Defendants’ denial of long term disability ("LTD") benefits under a long term disability plan ("LTD Plan") and certain life insurance benefits under two life insurance plans ("Life Insurance Plans"). All three plans are employee welfare benefits plans under ERISA obtained by Plaintiff though her employment. This matter comes before the Court upon Plaintiff's Motion to Serve Proposed Discovery [Doc. 24] in this case. For the reasons that follow, the Court DENIES Plaintiff's Motion to Serve Proposed Discovery.
II. Background
A. Facts
Plaintiff was employed by Pharmaceutical Product Development, LLC ("PPD") in Memphis as a Senior Remote Site Monitor. [Doc. 1, Complaint ¶ 19]. Plaintiff became a participant in the LTD Plan and the Life Insurance Plans through her employment at PPD. [Id. ¶ 20-21]. The Life Insurance Plans provide that if the Plaintiff becomes disabled, the life insurance premiums are waived and the Plaintiff continues to be covered under the Life Insurance Plans. [Id. ¶ 26]. This benefit is referred to as a Life Waiver of Premiums ("LWOP") benefit. [Id. ¶ 26].
All future references to the Complaint will be as follows: "Complaint ¶ __."
Plaintiff alleges that Unum Life Insurance Company ("Unum Life") and its parent company, the Unum Group Corporation ("Unum Group"), are the administrators, i.e., the parties obligated to determine eligibility for benefits under both the LTD Plan and the Life Insurance Plans. [Id. ¶ 9]. Defendants admit only that Unum Life is obligated to determine eligibility for benefits under the LTD Plan and the Life Insurance Plans, and deny that Unum Group is similarly obligated. [Complaint ¶ 9; Doc. 11, Answer ¶ 9]. Defendants, however, do admit that employees of Unum Group created and maintained a Benefits Center Claims Manual and document retention policy and state that "Plaintiff's claim was administered in accordance with the Benefits Center Claims Manual by employees of Unum Group acting on behalf of Unum Life." [Answer ¶ 17].
References to the Answer shall hereinafter be cited as "[Answer ¶ __]."
With respect to the source of payment of Plaintiff's claims if they are granted, Plaintiff alleges and Defendants admit that Unum Life is the party obligated to pay benefits under the LTD Plan and the Life Insurance Plans issued by Unum Life to PPD. [Complaint ¶¶ 10-12, Answer ¶¶ 10-12]. However, as previously noted, Unum Group is the parent company of Unum Life. Thus, as a practical matter, the Court concludes that Unum Group and Unum Life (collectively referred to as "Unum" or "Defendants") are both the administrator of the claims and payor of the benefits for the LTD Plan and the Life Insurance Plans at issue in this case. In other words, if Unum concludes Plaintiff qualifies for benefits under the two plans, then Unum will pay those benefits from its own funds.
Plaintiff ceased working on May 2, 2017. And, she asserts that the reason she stopped working was due to a disability caused by back impairments and carpal tunnel syndrome. [Complaint ¶¶ 28 - 34]. Plaintiff asserts she has been disabled under the terms of the LTD Plan and the Life Insurance Plans since May 2, 2017. [Id. ¶ 36.] Defendants deny this allegation. [Answer ¶ 36]. Plaintiff was paid all available short term disability payments. [Complaint ¶ 37]. Plaintiff was approved for LTD benefits on October 26, 2017, and LWOP benefits on April 20, 2018. [Id. ¶¶ 38-39]. Defendants terminated Plaintiff's LTD benefits on May 14, 2018, and terminated her LWOP benefits on May 15, 2018. [Id. ¶¶ 48-49].
Plaintiff alleges—and Unum denies—that Unum was influenced by its own financial interests when deciding these claims. Unum contends that the claims were decided based solely on their merit. [Complaint ¶¶ 57-58, Answer ¶¶ 57-58]. In this regard, Plaintiff makes specific allegations against Unum which Unum denies. Those allegations include:
• When Unum denies a claim before all contractual benefits are made, Unum refers to that process as a "recovery." [Id. ¶ 59].
• Unum sets monthly targets for the number of "recoveries" based on the total amount of money it has in its reserves to pay claims. The monthly targets are called "recovery plans." [Id. ¶¶ 61-62]. The recovery plans are comprised of the names of insured individuals and the reserve amount associated with those claims. [Id. ¶ 64].
• Vice Presidents in the claims department give these recovery plans to Assistant Vice Presidents in writing and verbally, who, in turn, give the recovery plans verbally to the Directors to "coach" them about claims decisions. Directors are the ultimate decisionmakers about whether to deny or grant claims. [Id. ¶¶ 63-68]. Hard copies of the recovery plans are shredded. [Id. ¶ 69].
• The Directors use this information to "guide" the claims handlers under them to deny meritorious claims in order to meet the recovery plan for their team. [Id. ¶ 70].
• To receive bonuses under Unum's incentive program, Unum's employees are evaluated against certain criteria, which include planned claim terminations, expected liability acceptance rates, and anticipated reopen rates. [Id. ¶ 71]. Targets and goals for claim closures are set at the unit level and goals are set each day for claims recoveries, i.e. for denying open claims. [Id. ¶ 72].
Plaintiff seeks the Court's permission to serve Unum with requests for admissions, interrogatories and requests for production of documents. Plaintiff asserts that these discovery requests are necessary to investigate whether Unum has a financial conflict of interest which improperly influenced Unum's decision to terminate Plaintiff's benefits under the LTD Plan and the Life Insurance Plans.
III. Analysis
It is well settled that a court's review under ERISA of a decision by a plan administrator to deny benefits under a qualified employee welfare benefit plan is limited to the administrative record upon which the decision was based. Firestone Tire & Rubber v. Bruch , 489 U.S. 101, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989) ; Univ. Hosps. of Cleveland v. Emerson Elec. Co. , 202 F.3d 839, 845 n. 1 (6th Cir. 2000) ; Wilkins v. Baptist Healthcare Sys., Inc. , 150 F.3d 609, 615 (6th Cir. 1998). In Wilkins , the Sixth Circuit laid out the one exception to this hard-and-fast rule: "The only exception to the above principle of not reciting new evidence at the district court level arises when consideration of the evidence is necessary to resolve an ERISA claimant's procedural challenge to the administrator's decision, such as an alleged lack of due process afforded by the administrator or alleged bias on its part." 150 F.3d at 615 (referencing VanderKlok v. Provident Life and Accident Ins. Co., Inc. , 956 F.2d 610, 617 (6th Cir. 1992) ). An inherent structural conflict of interest or bias exists when a party is both the plan administrator and pays benefits from its own funds. Metro. Life Ins. Co. v. Glenn , 554 U.S. 105, 128 S.Ct. 2343, 171 L.Ed.2d 299 (2008) ; Firestone Tire & Rubber Co. v. Bruch , 489 U.S. 101, 109 S.Ct. 948, 103 L.Ed.2d 80 (1989). Such a conflict of interest is a factor that must be considered when reviewing a plan administrator's decision to deny benefits. Id.
Here, Unum Group acts not only as the plan administrator—deciding whether to grant or deny claims—but its subsidiary, Unum Life, funds the reserves from which claims are paid. Consequently, as is common with insurers who provide LTD benefits and other types of insurance claims, an inherent conflict of interest exists in this case. In other words, Unum is a publicly-traded company with a duty to maintain an appropriate balance between premiums received (as well as investment dollars earned on those premiums) and benefits paid. It is the insurance industry's age-old institutional friction between underwriting and claims management. So, Plaintiff argues, Unum has a built-in disincentive to pay claims. Plaintiff seeks to compel discovery to determine whether Unum's claims personnel were influenced or pressured to deny Plaintiff's claim in order to protect the company's reserves instead of basing their decision solely upon the medical evidence.
There are two issues before the Court bearing on Plaintiff's Motion to Compel discovery. The first is whether Plaintiff must make a threshold showing of bias before being allowed to conduct discovery. And, if a threshold showing of bias is required, the second issue is how much evidence—and what sort of evidence—are necessary to meet that threshold.
A. A Threshold Showing of Bias is Required
Within this circuit, there is a split on the issue of the requirement of a threshold showing. Some courts have determined that no threshold showing is required in an ERISA case to conduct discovery into bias if the insurance company is both the administrator of the plan and the payor of benefits under the plan. See e.g., Johnson v. Connecticut General Life Ins. , 324 F. App'x 459, 466-467 (6th Cir. 2009) ; Gluc v. Prudential Life Ins. Co. of Am. , 309 F.R.D. 406, 412-13 (W.D. Ky. 2015) ; Back v. Hartford Life and Acc. Inc. Co. , 2010 WL 8938975, at *3-4 (E.D. Mich. 2010) ; Myers v. Prudential Ins. Co. of Am. , 581 F. Supp. 2d 904, 913-14 (E.D. Tenn. 2008). These unpublished cases are not binding on the Court.
On the other hand, there are several unpublished decisions in which the Sixth Circuit concluded that an initial showing of bias is required to permit discovery. See e.g., Guest-Marcotte v. Life Ins. Co. of N. Am. , 730 F. App'x 292, 304 (6th Cir. 2018) ; Collins v. Unum Life Ins. Co. of Am. , 682 F. App'x. 381, 389 (6th Cir. 2017) ; Putney v. Medical Mutual of Ohio , 111 F. App'x 803 (6th Cir. 2004). The rationale of these cases with respect to this issue is cogently summarized as follows in Guest-Marcotte :
The general rule in ERISA denial-of-benefits cases is that the district court's review is limited to the administrative record, and thus discovery is not available. See Moore v. Lafayette Life Ins. Co. , 458 F.3d 416, 430 (6th Cir. 2006). An exception exists, however, if discovery is sought "in support of a procedural challenge to the administrator's decision, such as an alleged lack of due process afforded by the administrator or alleged bias on its part." (quoting Wilkins v. Baptist Healthcare Sys., Inc. , 150 F.3d 609, 619 (6th Cir. 1998) ). To be entitled to such discovery, an ERISA claimant must first "provide sufficient evidence of bias—or of any procedural irregularity—to justify prehearing discovery.... [A] mere allegation of bias is insufficient to throw open the doors of discovery in an ERISA case." Likas v. Life Ins. Co. of N. Am. , 222 F. App'x 481, 486 (6th Cir. 2007) (internal quotation marks omitted). Here, the district court correctly concluded that Guest-Marcotte failed to make the necessary showing because she made only conclusory allegations of bias.
730 F. App'x at 304.
This second line of cases—encapsulated in Guest-Marcotte —is also not binding; however, the undersigned finds them to be more persuasive than the first line of non-binding cases in light of ERISA's goal "to provide a method for workers and beneficiaries to resolve disputes over benefits inexpensively and expeditiously." Perry v. Simplicity Eng'g , 900 F.2d 963, 967 (6th Cir. 1990). In doing so, the Court would note that Guest-Marcotte and Collins , decided in 2018 and 2017, respectively, are both recent decisions of the appellate court. With full access to the 2004 to 2009 line of cases relied upon by Plaintiff, at least some of the judges on the Sixth Circuit appear to be moving in a different direction with respect to the threshold requirement of an initial showing of bias before discovery will be allowed. Further, the approach articulated in Guest-Marcotte is consistent with the need to develop a cost-efficient, practical method of judicial review of ERISA cases. If plaintiffs are permitted to perform discovery in every case in which a disability plan administrator pays benefits from its own funds—without some additional threshold showing of a conflict of interest improperly motivating the claims determination—the general rule in ERISA cases that a court will limit its review to the administrative record will go by the wayside. Permitting extensive discovery in ERISA cases risks the likelihood that litigation expenses will approach or even outweigh the LTD benefits at issue, thus subverting the stated goal of resolving these disputes quickly and economically. Further, it would run contrary to the express purpose stated in Rule 1 of the Federal Rules of Civil Procedure, to wit , "[these rules] should be construed, administered, and employed by the court and the parties to secure the just, speedy, and inexpensive determination of every action and proceeding." Consequently, unless and until there is binding precedent to the contrary, the Court concludes that Plaintiff must make a threshold showing of bias to bypass the general rule prohibiting discovery in ERISA cases.
Since Guest-Marcotte was decided, this Court has considered twice the very question now before this Court. For the reasons cited above, on both occasions, the Court held that discovery into a conflict of interest on the part of a plan administrator who is also the payor requires more than a structural conflict of interest, i.e., the insurance company is both the plan administrator and the payor of benefits. Rather, there must be a threshold evidentiary showing that this structural conflict of interest infected the insurance company's decision making. See Mitchell v. Unum Life Ins. Co. of America , No. 1:18-cv-94, 2019 WL 7758859 (E.D. Tenn. Sept. 30, 2019) (Greer, J.); Sandeen v. The Paul Revere Life Ins. Co. , No. 1:18-cv-248 (E.D. Tenn. Oct. 23, 2019) (Greer, J.).
Both decisions provide a current catalogue of cases illustrating the two different approaches to discovery in ERISA actions. See Mitchell v. Unum Life Ins. Co. of America , No. 1:18-cv-94, slip op. at 5-7, 2019 WL 7758859, at *2–4 (E.D. Tenn. Sept. 30, 2019) (Greer, J.); Sandeen v. The Paul Revere Life Ins. Co. , No. 1:18-cv-248, slip op. at 5-7 (E.D. Tenn. Oct. 23, 2019) (Greer, J.).
B. Plaintiff Has Not Made a Threshold Showing of Bias.
Plaintiff asserts two bases for meeting the threshold showing of bias. First, Plaintiff argues that "the most glaring evidence that Unum did not fairly evaluate Ms. Olah's claim is its abrupt and unexplained decision to approve her claim in April 2018 and then deny her less than a month later when it admitted that no medical change had occurred." [Doc. 25, Pl.’s br. at 18]. Second, Plaintiff alleges that Defendants reviewed claims and made decisions about whether to pay or deny those claims based on the value of those claims and the amount of money in their reserves to pay such claims. In support of the second basis, Plaintiff has attached copies of depositions which, Plaintiff asserts, show improper, profit-based motives on the part of claims-personnel in Unum's Worcester, Massachusetts office. These two bases will be discussed separately.
1. Unum's Decision to Terminate Benefits is Not Sufficient Evidence of Bias
Plaintiff argues the evidence of her disability was so strong that the "abrupt" termination of benefits is evidence of bias. Unum disputes this argument and offers reasons why termination of benefits was appropriate. It is not, on its face, apparent to the Court that the termination of Plaintiff's benefits was inappropriately abrupt. The only way to resolve this particular dispute is to examine carefully the underlying administrative record, including plaintiff's medical records.
In support of her argument that consideration of the merits of her case is appropriate to determine if she has met the threshold requirement to obtain discovery from Unum, Plaintiff relies on language from Metropolitan Life Ins. Co. v. Glenn , 554 U.S. 105, 128 S.Ct. 2343, 171 L.Ed.2d 299 (2008) :
the court [of appeals] found questionable the fact that MetLife had encouraged Glenn to argue to the Social Security Administration that she could do no work, received the bulk of the benefits of her success in doing so (the remainder going to the lawyers it recommended), and then ignored the agency's finding in concluding that Glenn could in fact do sedentary work. See id. , [Glenn v. Metlife , 461 F.3d 660] at 666–669 [(6th Cir. 2006)]. This course of events was not only an important factor in its own right (because it suggested procedural unreasonableness), but also would have justified the court in giving more weight to the conflict (because MetLife's seemingly inconsistent positions were both financially advantageous).
Id. at 118, 128 S.Ct. 2343. Plaintiff asserts that this language establishes that the administrator's conduct in adjudicating the underlying claim can be evidence of bias which justifies discovery. The issue before the Supreme Court in Glenn was the Court's proper standard of review of an administrator's decision to deny a claim. The policy at issue in Glenn provided for a discretionary standard of review, but, the Glenn plaintiff argued, because the insurance company was both the administrator and payor of benefits, the Court should review the administrator's denial de novo. The Supreme Court rejected the plaintiff's argument and found the appropriate standard of review was still deferential. Id. at 115-16, 128 S.Ct. 2343. However, the Supreme Court also held that the structural conflict of interest in place should be considered as a factor when reviewing whether the administrator abused its discretion. Id. at 117-18, 128 S.Ct. 2343. The Supreme Court further concluded that the administrator's conduct in regard to Glenn's Social Security claim, as noted in the quote above, supported giving further weight to the structural conflict. Id. at 118, 128 S.Ct. 2343.
Similarly, in this case, if, upon a careful review of the administrative record, the Court finds the Administrator's decision to terminate benefits to be inexplicably abrupt, the Court can give more weight to the structural conflict; however, the Court declines to examine the underlying merits of the case at this stage of the litigation to determine if discovery into bias and procedure is appropriate.
Plaintiff's argument is inextricably entwined with the merits of her claim. In essence, Plaintiff is arguing that, because Unum's decision was arbitrary and capricious—as evidenced by its unreasonable decision to deny benefits—Plaintiff should be permitted to perform discovery concerning Unum's claims-handling practices. Respectfully, this approach would turn on its head the well-settled rule that a court's review under ERISA of a plan administrator's decision to deny benefits is limited to the administrative record. Nor does the Glenn decision require such a conclusion. If the Court were to adopt Plaintiff's argument, it would be endorsing an approach in which Plaintiff's arguments that a claims-denial decision is arbitrary and capricious would first be reviewed by the Court to determine whether such arguments support a showing of bias sufficient to open the door to discovery. This would necessitate a complete review of the administrative record at two different levels. In Sandeen v. The Paul Revere Life Ins. Co. , the plaintiff made the same argument and the undersigned Magistrate Judge—as well as the District Court upon review—reached the same conclusion, to wit , a decision to deny or terminate benefits is not, by itself, evidence of bias. See Sandeen v. The Paul Revere Life Ins. Co. , No. 18-cv-248-JRG-CHS, slip op. at 8, 2019 WL 13123500, at *4–5 (E.D. Tenn. July 3, 2019) (Steger, MJ); Sandeen , No. 1:18-cv-248-JRG-CHS, slip op. at 10-11 (E.D. Tenn. Oct. 23, 2019) (Greer, J.).
Plaintiff's arguments concerning the reasonableness of Unum's decisions should be appropriate at the dispositive motion stage as she seeks to demonstrate—on the basis of the administrative record—that Unum's decision was arbitrary and capricious; however, these arguments are not appropriate to establish bias. Requiring an examination of the entire administrative record at this stage would completely subvert the goal of an expeditious and inexpensive review of an employee's claim. The Court finds that these arguments do not support a threshold showing of bias on the part of Unum although they could certainly be relevant to a determination as to whether Unum's decision was well-founded or arbitrary and capricious.
2. Plaintiff Has Not Presented Evidence that Claims-Handlers Who Reviewed Her Claims Were Motivated by Improper Financial Considerations
In her second argument calculated to make a threshold showing of bias, Plaintiff makes specific allegations that Vice Presidents, Assistant Vice President, and Directors used information about the value of claims and the amount of money in Unum's financial reserves from which claims would be paid, to determine whether certain claims should be paid or denied. In other words, Plaintiff alleged in her Complaint that decisions to deny claims were being made in order to maintain reserve levels. In support of these allegations, Plaintiff submits deposition testimony and documents relating to former Unum employees in Unum's Worcester, Massachusetts, office to demonstrate that Unum established profit-driven expectations for its claims handlers which improperly influenced them to deny claims. For the most part, this is the same evidence plaintiffs relied upon in Mitchell v. Unum Life Ins. Co. of Am. , Case No. 1-18-cv-94, 2019 WL 7758859 and Sandeen v. The Paul Revere Life Ins. Co. , No. 18-cv-248, cases in which plaintiffs Mitchell and Sandeen sought to make an initial showing to seek leave to permit discovery into alleged bias by Unum Life Insurance Company.
Ms. Sandeen, Ms. Mitchell, and Ms. Olah are represented by the same law firm, so a very similar approach—and much of the same evidence—are being used in support of the motion to conduct discovery. The Paul Revere Life Insurance Company is a subsidiary of Unum Group.
In Mitchell , Sandeen , and this case, plaintiffs’ counsel argues that Unum has recovery plans to deny a sufficient number of LTD claims so as to meet certain goals with respect to both the dollar value and number of total claims approved. The Court recognizes that a conflict of interest would exist were a disability insurer to deny disability claims simply to make a profit; however, the Court also recognizes that an insurance company—at least at certain layers within the organization—must estimate numbers of claims that will remain open or be closed for purposes such as underwriting and establishment of reserves. That Unum formulates plans reflecting an estimate of the number of claims that ultimately will be concluded—whether such plans are referred to as recovery plans or by some other name—is not really the issue. Rather, the issue is who, within the Unum organization, has access to the information.
Plaintiff then argues that Unum's Vice President, Assistant Vice Presidents, and Director are made privy to the recovery plans and that such plans encourage Unum decision-makers to deny valid disability claims in order to meet company goals. Plaintiff also alleges that bonuses are provided for meeting those goals. The Complaint specifically refers to deposition testimony from Anthony Scuderi [Doc. 42-1] and Peter Paul [Doc. 25-6]. [Complaint ¶ 73-74]. Plaintiff identifies these excerpts of Mr. Scuderi's deposition as coming from Ginjupalli v. Provident Life and Accident Ins. Co. , No. 16-C-150, and the excerpts of Mr. Paul's deposition as coming from Biliack v. The Paul Revere Life Inc. , 2:16-cv-3631-DJH. As the Court did in Mitchell and Sandeen , the Court concludes that:
Plaintiff also states in her reply brief that she also relies on the testimony of Holly Crawford and Adam Stinson. [Doc. 34, Def.’s reply br. at 10]. But the brief does not state where this testimony can be found in the record and the Court cannot find it.
• The proffered testimony relied upon by Plaintiff's counsel relates to individual (not group) disability claims handled by claims personnel in Unum's Worcester, Massachusetts, claims office.
• None of the proffered testimony comes from claims personnel who were involved in any way with this
Plaintiff's group LTD disability claim or the denial of her life insurance benefits.
• The evidence offered by Plaintiff's counsel demonstrates that these select Worcester, Massachusetts, claims personnel were acting in contravention of Unum's written policies when they gained access to recovery plans or other claims metrics.
• Plaintiff's counsel offered no evidence that the Worcester claims personnel with access to recovery plans or other claims metrics were acting pursuant to a policy that emanated from Unum's corporate office in Chattanooga, Tennessee.
• Plaintiff's counsel offered no evidence that any claims personnel handling Unum's group LTD Disability claims in the Chattanooga, Tennessee, office had access to recovery plans or other claims metrics.
• Plaintiff's counsel offered no evidence that any claims personnel involved with the handling of this Plaintiff's group LTD Disability claim in the Chattanooga, Tennessee, office had access to recovery plans or other claims metrics.
Plaintiffs’ counsel—as they did in Mitchell and in Sandeen (and presumably as they will do in future ERISA claims filed against Unum in connection with the denial of LTD claims)—ask the Court to assume that, because a discrete number of Unum employees in a Worcester, Massachusetts, claims office testified that recovery plans were shared, in contravention of Unum's written policies, with employees responsible for making individual disability claims determinations in that office, then recovery plans may have been shared with Unum employees in Chattanooga, Tennessee, who were responsible for Plaintiff's group LTD or life insurance benefits claims determination.
Plaintiff Olah's argument as to why she should be permitted to perform discovery in this ERISA case is that the Unum employees responsible for making her disability claim determination have access to recovery plans or other claims metrics, and that they are under pressure to deny valid LTD or life insurance benefits claims to meet company financial goals. Her argument is based upon testimony from an employee in the Massachusetts office who was not involved in the determination of Plaintiff's claim which was administered and decided in Unum's Chattanooga, Tennessee, division.
In an effort to tie the Worcester, Massachusetts, division's alleged conduct to the Chattanooga, Tennessee, division, Plaintiff has submitted the declaration of Unum Group Assistant Vice President Laura Kilmartin. [Doc. 43-1]. In her declaration, Ms. Kilmartin stated that "the Benefits Center Manual was the only claim manual utilized by Unum Group employees for the handling of disability claims...." [Doc. 34-1, Kilmartin Decl. ¶ 2]. Unum has admitted that Unum Group employees, acting on behalf of Unum Life, review the disability claims pursuant to the Claims Benefit Manual. Ms. Kilmartin's statement also indicates that the Worcester division and the Chattanooga division are evaluating claims using the same Benefits Center Claims Manual. But, Plaintiff does not contend that that the Benefits Claims Manual itself establishes an unfair and biased procedure for evaluating claims. Rather, as previously discussed, Plaintiff alleges that Unum engaged in conduct outside the Benefits Claims Manual to deny or "recover" claims in order protect its financial bottom line. In Sandeen v. Paul Revere Life Ins. Co. , No. 1-18-cv-248, slip op. at 10, 2019 WL 13123500, at *5–6 (E.D. Tenn. July 3, 2019), this Court reviewed the same evidence presented by Plaintiff here concerning the conduct of the Worcester employees and this Court found the Worcester employees were acting in "contravention of Unum's written policies." Again, the Court emphasizes that Plaintiff has not alleged the Benefits Claims Manual itself establishes the biased and unfair procedures Plaintiff alleges Unum used to review her claim. That the Worcester division acted in contravention of the procedures in the Claims Benefit Manual does not demonstrate that the Chattanooga, Tennessee, claims personnel do as well. Further, Plaintiff has failed to establish any nexus between the individual disability claims about which Anthony Scuderi was testifying and Unum's claims-handling procedure and appeal process for group LTD claims. As the Sixth Circuit held in Guest-Marcotte :
To be entitled to ... discovery, an ERISA claimant must first "provide sufficient evidence of bias—or of any procedural irregularity—to justify prehearing discovery.... [A] mere allegation of bias is insufficient to throw open the doors of discovery in an ERISA case." Likas v. Life Ins. Co. of N. Am. , 222 F. App'x 481, 486 (6th Cir. 2007) (internal quotation marks omitted). Here, the district court correctly concluded that Guest-Marcotte failed to make the necessary showing because she made only conclusory allegations of bias.
730 F. App'x at 304. In the present case, the Court finds that Plaintiff's claim of bias is similarly conclusory and unsubstantiated. For that reason, the Court finds that Plaintiff is not entitled to conduct discovery in this case. See Collins v. Unum Life Ins. Co. of Am. , 682 F. App'x 381, 389 (6th Cir. 2017) (concluding that the district court did not abuse its discretion in denying additional discovery because Plaintiff did not "set forth evidence establishing more than a mere allegation of bias based on the inherent conflict of interest.").
IV. Conclusion
For the reasons stated herein, it is ORDERED that Plaintiff's Motion to Serve Proposed Discovery [Doc. 24] is DENIED .