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Kasko v. Aetna Life Ins. Co.

United States District Court, E.D. Kentucky, Central Division

July 21, 2014

LINDA E. KASKO, Plaintiff,
v.
AETNA LIFE INSURANCE COMPANY, Defendant

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[Copyrighted Material Omitted]

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For Linda E. Kasko, Plaintiff: Robert Scott Wilson, LEAD ATTORNEY, PRO HAC VICE, Eric Buchanan & Associates, PLLC, Chattanooga, TN.

For Aetna Life Insurance Company, Defendant: Eric P. Mathisen, LEAD ATTORNEY, Ogletree, Deakins, Nash, Smoak & Stewart, P.C. - Valparaiso, Valparaiso, IN.

Page 785

MEMORANDUM OPINION AND ORDER

Danny C. Reeves, United States District Judge.

This matter is pending for consideration of Plaintiff Linda E. Kasko's (" Kasko" ) motion to compel discovery regarding whether a conflict of interest influenced Defendant Aetna Life Insurance Company's (" Aetna" ) decision to deny her claim for long-term disability (" LTD" ) benefits. [Record No. 15] Having reviewed the briefs filed in support of the parties' respective positions, the Court will grant a portion of the relief sought.

I.

Kasko was covered through her former employer, InVentiv Health, under a group LTD plan governed by the Employee Retirement Income Security Act of 1974 (" ERISA" ), 29 U.S.C. § 1001, et seq. Kasko claims that she was disabled and stopped working on July 9, 2011. [Record No. 1, p. 3] As a result, she filed a claim for LTD benefits with Aetna. The claim was denied. In addition to providing LTD coverage to InVentiv, Aetna administers the plan.

Kasko filed this action on July 31, 2013, alleging that the decision to deny her claim for LTD benefits was arbitrary, capricious and not supported by substantial evidence. She further asserts that " the decision to deny LTD benefits was under a perpetual conflict of interest because the benefits would have been paid out of its own funds." [Record No. 1, ¶ 27] Kasko also contends that the decision to deny her claim for LTD benefits was influenced by the reviewing doctors' conflicts of interest. [Record No. 25, p. 4]

On January 24, 2014, Kasko served the defendant with seven interrogatories and five requests for production of documents. Aetna objected to a number of the discovery requests. Thereafter, Kasko moved the Court to compel Aetna to respond. [Record No. 14] The discovery subject to Aetna's objections and Kasko's motion concerns a potential conflict and bias of doctors hired by Aetna to review Kasko's benefits claim. [Record No. 15]

II.

A. Discovery Outside the Administrative Record

Generally, an ERISA claimant may not seek discovery regarding matters outside the administrative record. See Wilkins v. Baptist Healthcare Sys., Inc., 150 F.3d 609, 618 (6th Cir. 1998) (noting that a district court may not ordinarily consider new evidence). This is based on two governing principles. First, the reviewing court's determination is not whether a claimant is eligible for benefits, but rather whether the administrator's decision was proper, based on the administrative record. See Perry v. Simplicity Eng'g, 900 F.2d 963, 966 (6th Cir. 1990) (holding that under either " de novo" or

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" arbitrary and capricious" standard, court's review is limited to the record). Second, limitations regarding discovery furthers ERISA's primary goal; that is, the inexpensive and expeditious ...


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