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Irina Ulyanenko v. Metropolitan Life Insurance Company

June 3, 2011

IRINA ULYANENKO, PLAINTIFF,
v.
METROPOLITAN LIFE INSURANCE COMPANY
AND LIFE INSURANCE COMPANY OF NORTH
AMERICA, DEFENDANTS.



The opinion of the court was delivered by: Kevin Nathaniel Fox United States Magistrate Judge

MEMORANDUM and ORDER

INTRODUCTION

The plaintiff brings this action, pursuant to the Employee Retirement Income Security Act of 1974 ("ERISA"), 29 U.S.C. § 1001 et seq., to recover benefits from the Life Insurance Company of North America ("LINA"), the administrator of her deceased daughter's accidental death policy. Before the Court is the plaintiff's motion, pursuant to Fed. R. Civ. P. 37, to strike the defendant's answer and enter judgment, by default.

BACKGROUND

On March 2, 2009, the plaintiff initiated this action against the Metropolitan Life Insurance Company ("MetLife") and CIGNA Life Insurance Company of New York ("CIGNA") in the New York State Supreme Court, New York County. On April 7, 2009, CIGNA removed the action to this court. On April 30, 2009, the court substituted defendant CIGNA with LINA and, on October 8, 2009, the court dismissed the action against MetLife, leaving LINA the sole defendant.

On May 7, 2009, the assigned district judge, the Honorable Lewis A. Kaplan, put in place a case management plan, wherein he directed the parties to complete all discovery on or before September 9, 2009. Judge Kaplan later extended the discovery completion deadline to January 15, 2010.

On July 13, 2009, the plaintiff served LINA with her first request for documents, seeking production of LINA's administrative file "including all rules and regulations, contracts, policies, [and] correspondences[] regarding the insurance policy for [the] decedent[.]" On August 5, 2009, LINA served its response to the plaintiff's first request for documents, claiming all responsive documents were produced previously, on May 27, 2009, with LINA's initial disclosures.

On October 9, 2009, the plaintiff served LINA with a notice of deposition, to which she appended a request for documents, which resembled her first request for documents. Specifically, the plaintiff sought from LINA: (1) all documents involving the decedent; and (2) all rules, regulations, policies and directives for "the determination of administering benefits[.]" On October 19, 2009, LINA objected to the deposition, claiming it was noticed improperly and, in any event, such discovery was improper, absent a showing of good cause.*fn1 More than three months later, on February 4, 2010, the plaintiff filed a motion to compel LINA's deposition. On February 9, 2010, Judge Kaplan granted the plaintiff's motion, finding that she had established good cause.

On March 3, 2010, as the deposition approached, the plaintiff supplemented, via an e-mail message, her request for production from LINA, by requesting several broad categories of documents. The plaintiff, in essence, requested: (1) all records pertaining to LINA claims processing generally and, in particular, claims involving gender, pregnancy, clots, embolisms, thromboembolism, genetics and genetic predispositions; (2) data on the number of claims, in the past 10 years, involving clots, embolisms, thromboembolism, genetics, genetic predispositions, oral contraceptives, women and men, which were (a) initially denied, and (b) ultimately paid; and (3) all records relating to LINA's evaluation and promotion criteria. LINA objected to these new requests, on the ground that they were outside the scope of the deposition notice. To resolve this, and other disputes pertaining to the deposition, Judge Kaplan held a telephonic conference with the parties on March 4, 2010. No record exists from that conference, leaving the Court unable to determine what, if anything, Judge Kaplan ordered with respect to document production.*fn2

On March 9, 2010, the plaintiff deposed Sandra S. Smith ("Smith"), a LINA accident specialist who initially denied the plaintiff's claim for benefits. The deposition occurred in Pittsburgh, Pennsylvania, and LINA paid, voluntarily, the travel and accommodation expenses for the plaintiff's counsel. During Smith's deposition, the plaintiff's counsel requested the following additional documents be produced: (1) transcripts of Smith's two prior depositions and the pleadings in those cases; (2) the annual performance goals LINA uses to evaluate accident specialists ; (3) the training manual for accident specialists; and (4) the accidental death policy in place prior to that in effect when the plaintiff's daughter died.

On July 20, 2010, Judge Kaplan held a hearing with the parties, and ordered LINA to produce: (1) "all of the documents that were requested by the plaintiff up to the time of the March 4 telephone conference"; (2) "all of the documents that were requested during the Smith deposition"; (3) "the original claim file or an affidavit by a person with personal knowledge stating that she has compared the original claim file with the copy that was produced earlier to the plaintiff and that the copy that was produced is a complete, true, and accurate copy of the original and all of its parts"; and (4) Rene Worst ("Worst") for a deposition in New York, on an date agreeable to the parties. During the conference, Judge Kaplan noted that LINA had delayed this action for at least four months and caused the plaintiff's counsel to go to Pittsburgh for "no good reason" to depose Smith, who was not the individual who ultimately denied the plaintiff's claim. Judge Kaplan denied the plaintiff's motion for sanctions "with respect to what has gone on up until now," without prejudice to renewal "if there is any future problem in this case." Thereafter, in an order, dated July 30, 2010, Judge Kaplan denied LINA's letter motion, requesting entry of a protective order, noting that LINA "has been engaged in obstruction of discovery in this action for some time."

On August 4, 2010, LINA served the plaintiff with its Responses to Plaintiff's Discovery Demands Pursuant to July 20, 2010 Court Order ("August 4 Responses"). In its August 4 Responses, LINA provided the plaintiff data concerning the number of claims made, initially denied and ultimately paid involving men and women. Along with the August 4 Responses, LINA produced:

(1) "the complete version of its policies & procedures manual that was in effect during the relevant time period to the best of its ability"; (2) a copy of the "SRO Manual in effect at the time of the plaintiff's claim"; (3) a transcript of a prior deposition of Smith and pleadings from the corresponding case; and (4) Smith's annual performance goals.

Moreover, LINA provided the plaintiff with affidavits from Brian Billeter ("Billeter") and Michael James ("James"). Billeter, LINA's regional claims manager for accident claims, attests to having personal knowledge of LINA's computer systems for accidental death and dismemberment claims ("AD&D claims") and LINA's storage and retention policies and procedures for AD&D claims. According to Billeter, "[w]hen an AD&D claim is received by LINA, it is entered into the electronic system and coded based on certain general identification information about the claimant and the coverage at issue." As a result, Billeter represents that "[t]here are no electronic codes utilized by LINA in connection with [AD&D claims] which would allow LINA to run electronic reports or . . . identify claims related to clots/embolisms/thromboembolisms, genetics/genetic predisposition, and/or oral contraceptives." Billeter states that the only way to obtain such information would be to conduct a manual search of more than 25,000 AD&D claims reviewed by LINA in the last ten years, which he estimates could take years to complete. Morever, Billeter states that LINA: (1) does not have any documents relating to the criteria for awarding bonuses, raises, and/or promotions; and (2) has not been fined by any state attorney general between 2005 and 2007, for reasons related to AD&D claims.

James, a LINA operations representative for life and accident claims, attests to comparing the plaintiff's original claim file with the copy that was produced earlier to the plaintiff and that the copy is a complete, true and accurate reproduction of the original and all of its parts. James states ...


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