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Winkler v. Metropolitan Life Insurance Co.

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK


September 28, 2006

MARK WINKLER, PLAINTIFF,
v.
METROPOLITAN LIFE INSURANCE COMPANY, DEFENDANT.

The opinion of the court was delivered by: Shira A. Scheindlin, U.S.D.J.

MEMORANDUM OPINION AND ORDER

On August 10, 2006, this Court awarded Mark Winkler $303,098.92 in attorney's fees and costs.*fn1 Metropolitan Life Insurance Company ("MetLife") now moves for reconsideration of this award under Rule 6.3 of the Local Rules of the United States District Courts for the Southern and Eastern Districts of New York ("Local Civil Rule 6.3"). Alternatively, MetLife moves for a stay of the entry and execution of the Fee Order until a final judgment is entered in this action.*fn2 For the following reasons, defendant's motions are denied.

STANDARD OF REVIEW

Motions for reconsideration are governed by Local Civil Rule 6.3 and are committed to the sound discretion of the district court.*fn3 "The standard for granting such a motion is strict, and reconsideration will generally be denied unless the moving party can point to controlling decisions or data that the court overlooked-matters, in other words, that might reasonably be expected to alter the conclusion reached by the court."*fn4 Reconsideration is an "extraordinary remedy to be employed sparingly in the interests of finality and conservation of scarce judicial resources."*fn5 Local Civil Rule 6.3 is narrowly construed and strictly applied in order to avoid repetitive arguments already considered by the Court.*fn6 A motion for reconsideration is not a substitute for appeal.*fn7 Nor is it "a 'second bite at the apple' for a party dissatisfied with a court's ruling."*fn8 Accordingly, the moving party may not "advance new facts, issues or arguments not previously presented to the Court."*fn9

II. DISCUSSION

MetLife argues that the Court's application of the five Chambless*fn10 factors was "perfunctory" and that the fee award was "virtually automatic."*fn11 Specifically, MetLife argues that the Court overlooked the particular facts and history of this case by failing to weigh the degree of culpability on the part of MetLife.*fn12 MetLife further argues that the Court's analysis with regard to the third, fourth and fifth Chambless factors was also in error.*fn13 With the exception of the Court's ruling on the fifth Chambless factor, MetLife has not presented any controlling law or factual matters which were overlooked by this Court. Thus, most of MetLife's arguments should be raised on appeal, not in a motion for reconsideration. However, to further explain the reasoning underlying the Fee Order, I will address all of MetLife's arguments.

A court has the discretion to award reasonable attorney's fees to either party in an action brought under the Employee Retirement Income Security Act of 1974 ("ERISA").*fn14 In general, "attorney's fees may be awarded to the prevailing party under ERISA in the absence of some particular justification for not doing so."*fn15 "[P]laintiffs may be considered 'prevailing parties' if they succeed on any significant issue in litigation which achieves some of the benefit the parties sought in bringing suit."*fn16 In other words, "plaintiffs must at least 'demonstrate a change in the legal relationship' between them and defendants as a result of the lawsuit."*fn17 Thus, a plaintiff "need not recover all the relief he seeks in order to qualify as a prevailing party for purposes of a fee-shifting statute [such as ERISA]."*fn18 Furthermore, ERISA's fee provisions should be liberally construed in favor of protecting those who participate in employee benefits plans.*fn19 Finally, the failure to prevail on one Chambless factor is not necessarily dispositive.*fn20

In the instant case, the Court analyzed the Chambless factors and found that all of them supported a fee award.*fn21 With regard to the first factor, I found that MetLife engaged in culpable conduct, citing a recent district court case for the proposition that "an arbitrary and capricious determination by an administrator or a failure to conduct a full and fair review in connection with a plaintiff's claims for benefits satisfies the culpability factor."*fn22 On appeal of this Court's decision denying Winkler's claim for benefits, the Second Circuit found that MetLife's decision to deny Winkler benefits was arbitrary and capricious. The Second Circuit summarized MetLife's misconduct in the following words:

First, MetLife failed to weigh the evidence in concluding that Winkler was terminated by his employer, Jack Morton Co. ("Company"), for reasons unrelated to his disability (a combination of depression, other psychiatric conditions, and HIV medication side effects). MetLife relied on a cursory statement by the Company's Human Resources department that Winkler's performance was "satisfactory," while dismissing as mere "lay opinions" detailed statements by several of Winkler's former colleagues, including superiors. . . . An administrator may, in exercising its discretion, weigh competing evidence, but it may not, as MetLife did here, cherry-pick the evidence it prefers while ignoring significant evidence to the contrary.

Second, MetLife's final denial relied (as had its consultants) on the absence of any objective cognitive testing, notwithstanding that MetLife never raised this issue with Winkler during the various stages of his application and appeal. . . .

Third, MetLife dismissed statements by Winkler's treatment providers simply because they were made soon-after, as opposed to before, his termination and because these providers did not contemporaneously document his employment disability before termination.

Fourth, MetLife based its decision entirely on the opinions of three independent consultants who never personally examined Winkler, while discounting the opinions of Winkler's three treatment providers and one independent examiner. . . . MetLife's exclusive reliance on second-hand opinions adds to the overall picture of its decision as less than fair.*fn23

In accordance with Second Circuit case law,*fn24 the conduct described above reflects a level of culpability that clearly supports an award of attorney's fees.*fn25

MetLife also takes issue with the Court's conclusions regarding the third, fourth and fifth Chambless factors. With respect to the third Chambless factor, MetLife argues that its "choices . . . cannot deter similar choices by other claim administrators because they can be reasonable choices in the context of particular facts and circumstances."*fn26 Therefore, according to MetLife, "the deterrent value of a fee award in this case is minimal at best."*fn27 MetLife cites a lower court decision in Robinson v. Metropolitan Life Insurance Company.*fn28 In Robinson, the court held that MetLife's referral of the plaintiff's claim to an internist rather than a neurological specialist was "rational, albeit erroneous, and there is no reason to believe that an award of attorney's fees would be an efficient deterrent to similar well-meaning misclassifications in the future."*fn29 Here, the Second Circuit held that MetLife "cherry-picked" the evidence MetLife viewed as favorable. Unlike Robinson, where a relatively minor mistake was made in good faith, MetLife's misconduct here was intentional. A substantial fee award will serve to deter both MetLife and other insurers from disregarding proper procedures in deciding disability claims. Thus, Robinson is both distinguishable and not controlling.

MetLife argues, with respect to the fourth Chambless factor, that the relative merits of the parties' positions are neutral given that Winkler's disability claim has yet to be decided by MetLife's claim administrator upon remand.*fn30 A similar argument was addressed in Cook v. New York Times LTD Plan, where the trial court stated:

Defendant's second argument is that because plaintiff was granted a remand instead of summary judgment, defendant should not be forced to pay fees, as plaintiff may never obtain the relief she seeks. This is irrelevant. ERISA provides that a beneficiary may bring a civil lawsuit "to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan." 29 U.S.C. § 1132(a)(1)(B). Attorneys' fees in ERISA cases are not granted based on counsel's efforts to obtain disability benefits before a plan administrator, but based on their efforts to vindicate their clients' rights in court. See id. § 1132(g). Plaintiff sought benefits by applying to the Plan in the first instance, not to the Court. She succeeded in overturning the Plan's adverse determination, and in achieving a right to submit additional proof of disability to the Plan, and she will now return to seek those benefits there again. [T]his Court cannot and will not reduce the award by speculating about whether plaintiff's claim for benefits will ultimately fail.*fn31

With regard to the fifth Chambless factor - whether the action conferred a common benefit on a group of plan participants - MetLife points out that Winkler only sought relief for himself.*fn32 According to MetLife, its "conduct in adjudicating this claim was not fundamentally flawed so as to result in changes in claim procedures, but rather represented choices which could be viewed as reasonable in the context of the specific facts and circumstances."*fn33 MetLife relies on Locher v. UNUM Life Insurance Company of America.*fn34 in support of its argument. In analyzing the fifth Chambless factor, the district court in Locher held that although plaintiff's case was not a common fund case, her action "served to bring under scrutiny the application of questionable evaluation practices . . . and thus provided an opportunity to increase knowledge and improve procedures in a way that may ultimately benefit others."*fn35 On appeal, the Second Circuit stated that it "has not yet recognized such circumstances" as satisfying the fifth factor.*fn36 Assuming, arguendo, that Winkler has not satisfied the fifth Chambless factor, the result would remain unchanged. Four out of five factors would still favor a fee award. Moreover, the Second Circuit has noted that "failure to satisfy the fifth Chambless factor does not preclude an award of attorneys' fees."*fn37 In sum, for the reasons stated above, the motion for reconsideration of the fee award is denied. MetLife remains liable for attorney's fees and costs in the amount of $303,098.92.*fn38

Finally, MetLife requests that the Fee Order be stayed until the Court issues a final judgment in this case.*fn39 MetLife argues that a stay is needed to preserve its right to appeal the Fee Order.*fn40 This argument makes no sense. This Court's May 25, 2006 Order remanding the case to MetLife is a final order. Even if this Order is not final, the subsequent Fee Order is appealable as a collateral order.*fn41 Because MetLife can immediately appeal the Fee Order, a stay is not required. MetLife's request for a stay is therefore denied.

III. CONCLUSION

For the foregoing reasons, defendant's motion for reconsideration of the Fee Order and its motion to stay that Order are denied. MetLife is directed to pay attorney's fees and costs in the amount of $303,098.92 to the law firm of Reimer & Associates LLC by October 31, 2006. The Clerk of the Court is directed to close these motions (Document # 79).

SO ORDERED


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