Porter v. Kaiser Foundation Health Plan

Full title: ANDREW PORTER, DENNIS PORTER, by and through their mother and next friend…

Court: United States District Court, D. Colorado

Date published: Aug 15, 2011

Civil Action No. 11-cv-00314-WYD-MJW (D. Colo. Aug. 15, 2011)

Opinion

Civil Action No. 11-cv-00314-WYD-MJW.

August 15, 2011

ORDER REGARDING PLAINTIFF'S MOTION FOR DISCOVERY (DOCKET NO. 18)

MICHAEL WATANABE, Magistrate Judge

This matter is before the court on Plaintiffs' Motion for Discovery (docket no. 18). The court has reviewed the subject motion (docket no. 18), the response (docket no. 24), and the reply (docket no. 29). In addition, the court has taken judicial notice of the court file and has considered applicable Federal Rules of Civil Procedure and case law. The court now being fully informed makes the following findings of fact, conclusions of law, and Order.

FINDINGS OF FACT AND CONCLUSIONS OF LAW

The court finds:

1. That I have jurisdiction over the subject matter and over the parties to this lawsuit;

2. That venue is proper in the state and District of Colorado;

3. That each party has been given a fair and adequate opportunity to be heard;

4. That this is an ERISA action wherein Plaintiffs seek coverage for ABA autism therapy;

5. That the subject motion (docket no. 18) seeks an Order from this court allowing discovery pursuant to Fed.R.Civ.P. 26(b) relating to Defendant's alleged dual role conflict of interest, the completeness and accuracy of the administrative record, and whether Defendant provided Plaintiffs with a full and fair review. In particular, Plaintiffs claim a dual role conflict of interest exists because Health Plan "is both the plan administrator and payor of benefits." See subject motion (docket no. 18) at page 8. However, Plaintiffs do not allege, nor have they offered any support, for the conclusion that Health Plan has a financial interest in the benefit determination. Moreover, it is undisputed that Health Plan is a nonprofit corporation;

6. That the issue before this court in this ERISA action is whether Health Plan's Interpretation of the Mental Health Services Exclusion was arbitrary and capricious; and

7. That the Tenth Circuit has "emphasize[d] that neither a claimant nor an administrator should be allowed to use discovery to engage in unnecessarily broad discovery that slows the efficient resolution of an ERISA claim." See Murphy v. Deloitte Touche Group Ins. Plan, 619 F.3d 1151, 1162-63 (10^th Cir. 2010). Furthermore, the Murphy court indicates that discovery should be disallowed beyond the administrative record regarding the merits of the claim under ERISA.

ORDER

WHEREFORE, based upon these findings of fact and conclusions of law this court ORDERS:

1. That Plaintiffs' Motion for Discovery (docket no. 18) is DENIED; and

2. That each party shall pay their own attorney fees and costs for this motion.