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Mead v. Reliastar Life Ins. Co.

United States Court of Appeals, Second Circuit

September 16, 2014

SUSAN MEAD, Plaintiff-Appellee,
v.
RELIASTAR LIFE INSURANCE COMPANY, Defendant-Appellant

Submitted August 23, 2011

Page 103

On plaintiff-appellee's motion to dismiss defendant's appeal from a December 17, 2010 judgment of the United States District Court for the District of Vermont (Sessions, J.), the plaintiff contends that we are without appellate jurisdiction under 28 U.S.C. § 1291 because the district court did not enter a final judgment but instead remanded her claim for ERISA benefits to the insurance plan administrator for further consideration.

Jonathan M. Feigenbaum, Boston, Massachusetts, for Plaintiff-Appellee.

William D. Hittler, Nilan Johnson Lewis PA, Minneapolis, Minnesota, for Defendant-Appellant.

Matthew B. Byrne, Gravel & Shea, Burlington, Vermont, for Defendant-Appellant.

Before: WINTER and HALL, Circuit Judges.[*]

OPINION

Page 104

It is hereby ORDERED that the motion to dismiss is GRANTED and the appeal is DISMISSED.

Per Curiam:

Susan Mead participated in a group long-term disability (" LTD" ) insurance policy administered by Reliastar Life Insurance Company (" Reliastar" ). Mead, who suffers from degenerative cervical disc disease, sought LTD benefits under this policy, asserting that her " total disability" prevented her from performing her own occupation or any other. Reliastar denied her claim, causing Mead to bring this action pursuant to the Employee Retirement Income Security Act of 1974 (" ERISA" ) in which she seeks a declaratory judgment that she is entitled to the LTD benefits. Finding Reliastar's benefits determination arbitrary and capricious, the district court remanded the matter to the company with instructions that it calculate the amount of benefits owed to Mead because she was unable to perform the duties of her own occupation and determine whether she was eligible for additional benefits because she could not perform the duties of any other occupation. Reliastar appealed, and Mead now moves to dismiss for lack of appellate jurisdiction, arguing that the remand order is not a " final decision" under 28 U.S.C. § 1291. While this is a familiar issue in this circuit, we have never definitively decided whether, or under what circumstances, a district court's remand to an ERISA plan administrator is immediately appealable. We hold that under the circumstances of this case, the remand order is not an immediately appealable final decision under either the traditional principles of finality or our precedents governing remands to administrative agencies. We therefore dismiss Reliastar's appeal for lack of appellate jurisdiction.

BACKGROUND

I. Mead's Group Insurance Policy

Mead was a long-time employee of Reliastar Financial Corporation (" Reliastar Financial" ) who ended her tenure there in 2000. In connection with her employment, Mead participated in a group LTD insurance policy administered by Reliastar (the " Plan" ). Under the Plan, Mead was eligible upon a showing of " total disability" to receive two forms of LTD benefits covering separate temporal periods. First, she could receive " own occupation" LTD benefits for up to 24 months if she demonstrated that her disability prevented her from performing the duties of her own occupation. After the expiration of this 24-month period, Mead could continue to receive " any occupation" LTD benefits by showing that her disability made her unable to perform the duties of any occupation for which she was qualified or could reasonably become qualified.

II. Proceedings before the Plan Administrator and District Court

In 2003, Mead submitted a claim for LTD benefits under the Plan, asserting that her degenerative cervical disc disease

Page 105

prevented her from working.[1] Reliastar denied the claim, concluding that Mead had not shown that she was unable to perform the duties of her own occupation. Mead then filed a federal complaint pursuant to Section 502(a)(1)(B) of ERISA, 29 U.S.C. § 1132(a)(1)(B), seeking a declaratory judgment that she was entitled to 24 months of " own occupation" benefits, plus interest. In subsequent filings, she also sought " any occupation" benefits covering the time between the end of the initial 24-month period and the date of the district court's judgment. The parties cross-moved for summary judgment and, in March 2008, the district court remanded the matter to Reliastar for further proceedings. See Mead v. Reliastar Ins. Co., No. 05-cv-332, 2008 WL 850675, at *1 (D. Vt. Mar. 27, 2008) (Sessions, J.). The court held that Reliastar's denial of Mead's claim for " own occupation" LTD benefits was " arbitrary and capricious" because it was " impossible to tell" which evidence Reliastar credited and which evidence it rejected to arrive at its decision. [WL] at *4.

On remand, Reliastar reviewed additional evidence but again denied Mead's claim, finding that she was not " totally disabled" and thus ineligible for " own occupation" LTD benefits covering the initial 24-month period, or, by implication, for " any occupation" LTD benefits covering the time after that initial period. Mead sought judicial review of this determination by again moving for summary judgment in the district court that had remanded the case. In her papers, Mead sought judgment awarding her LTD benefits " retroactive to the first date of eligibility" --a timeframe that covered both the initial 24-month " own occupation" benefits period and the latter " any occupation" benefits period.

In December 2010, after Reliastar cross-moved for summary judgment, the district court again remanded to Reliastar. See Mead v. Reliastar Ins. Co., 755 F.Supp.2d 515, 517 (D. Vt. 2010). The court held that Reliastar's denial of Mead's claim for " own occupation" benefits was arbitrary and capricious. Id. at 542. Among other flaws it identified in Reliastar's reasoning, the court highlighted that to arrive at the conclusion that Mead was not " totally disabled," Reliastar had " ignored" several physical requirements of Mead's former position, refused to recognize the " ample" objective evidence supporting her subjective complaints of pain, and provided " obviously false or misleading reasons" for discrediting the conclusions of its own neurologist. See id. at 529-42. Based on these flaws, the court held that Reliastar's determination as to Mead's eligibility for " own occupation" benefits was patently " unreasonable" and, as a result, it would be " inappropriate" to remand this eligibility determination for a second time. Id. at 542. Noting that Reliastar had never addressed the amount of " own occupation" benefits owed to Mead, however, the district court remanded that issue for Reliastar to make the required calculation. Id. Turning to Mead's request for " any occupation" benefits, the court observed that Reliastar had found her ineligible for these benefits based solely on its determination that she was not " totally disabled" during the initial 24-month " own occupation" benefits ...


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