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Trahan v. Metropolitan Life Insurance Co.

United States District Court, W.D. Louisiana, Monroe Division

January 23, 2019

KEVIN TRAHAN
v.
METROPOLITAN LIFE INSURANCE COMPANY

          TERRY A. DOUGHTY, JUDGE.

          REPORT AND RECOMMENDATION

          KAREN L. HAYES, MAGISTATE JUDGE.

         Before the undersigned magistrate judge, on reference from the District Court, is a motion to dismiss for failure to state a claim upon which relief can be granted, or alternatively, motion for summary judgment [doc. # 5] filed by defendant, Metropolitan Life Insurance Company (“MetLife”). Also before the court are three motions filed by plaintiff Kevin Trahan: 1) a motion to strike defendant's exhibit [doc. #12]; 2) a motion to compel defendant to produce a copy of the administrative record [doc. # 22]; and 3) a motion to deem plaintiff's reply brief also to be a supplemental opposition memorandum [doc. 23]. For reasons detailed below, it is recommended that defendant's motion to dismiss/summary judgment be DENIED. Moreover, it is ORDERED that plaintiff's motions are DENIED.

         Background

         On September 25, 2018, Kevin Trahan filed the instant suit against MetLife for its alleged arbitrary and wrongful failure to pay benefits under a long term disability policy that Trahan subscribed to during his employment with Performance Entergy and Quanta Services, Inc. (Compl.). Trahan seeks resulting damages, including penalties, reasonable attorney's fees, and legal interest. Id.

         On October 31, 2018, MetLife filed the instant motion to dismiss for failure to state a claim upon which relief can be granted, or alternatively for summary judgment, on the basis that Trahan purportedly failed to exhaust administrative remedies before filing suit as required by the Employee Retirement Income Security Act of 1974 (“ERISA”). In support of its motion, MetLife submitted portions of the administrative record, including the long term disability plan, and an affidavit from Matthew Hallford, a MetLife litigation specialist. See doc. #s 9-10.

         On November 21, 2018, plaintiff filed his opposition to MetLife's motion to dismiss/motion for summary judgment. [doc. # 11]. He argued that the motion was premature because MetLife had not furnished plaintiff or the court with a complete copy of the administrative record. Trahan further argued that he exhausted the administrative appeal requirements. Finally, he asserted that MetLife instituted an invalid internal claim process because it required claimants/beneficiaries to shoulder the financial burden of supplying the plan administrator with copies of records, reports, and medical services.

         In conjunction with his opposition brief, plaintiff filed a motion to strike [doc. # 12] the affidavit of Matthew Hallford submitted by MetLife because litigants ordinarily are not permitted to offer evidence outside the four corners of the administrative record.

         On November 27, 2018, MetLife filed its reply brief in support of its motion to dismiss/summary judgment. [doc. # 15]. On November 29, 2018, MetLife obtained leave of court to amend/correct its exhibits submitted in support of its motion to dismiss. [doc. #s 14, 16-18].[1]

         MetLife filed its opposition to plaintiff's motion to strike on December 13, 2018. [doc. # 19]. Plaintiff filed his reply brief on December 19, 2018. [doc. # 21].

         Trahan filed two additional motions on December 19: 1) a motion to deem [doc. # 23] his reply brief in support of his motion to strike as a supplemental memorandum in opposition to MetLife's motion to dismiss/summary judgment; and 2) a motion to compel [doc. # 22] MetLife to prepare and file a complete administrative record so plaintiff could proceed to the merits of the case.

         On January 2, 2019, the court reviewed the record and noted that plaintiff's complaint failed to allege any basis for the court's exercise of subject matter jurisdiction. (Jan. 2, 2019, Order [doc. # 25]). Accordingly, the court granted plaintiff leave to amend his jurisdictionally bereft complaint. Id.

         On January 10, 2019, plaintiff amended his complaint to invoke the court's federal question jurisdiction, 28 U.S.C. § 1331, on the basis that he was seeking benefits due under the terms of an ERISA disability plan issued by his employer. (Pl. Amend. Compl.). He alternatively asserted that the court enjoyed diversity jurisdiction, 28 U.S.C. § 1332, because the parties were completely diverse, and the amount in controversy exceeded $75, 000. Id.[2] Plaintiff also “acknowledge[d] that any state claim he might otherwise have has probably been preempted by ERISA, but to the extent that the evidence presented hereafter may show the existence of any non-pre-empted state claim, plaintiff would show that there is supplemental jurisdiction over any such claim under 28 U.S.C. 1367.” Id.

         In his amended complaint, plaintiff conceded that there had been a previous proceeding involving the same parties and related issues before this court, Trahan v. Metropolitan Life Insurance Co., No. 15-2803 (W.D. La.) (“Trahan I”). Plaintiff agreed that in Trahan I, this court rendered judgment on the merits in MetLife's favor as to his claims under a short term disability plan, and dismissed without prejudice his claims under the long term disability plan. Id. Plaintiff then proceeded to incorporate the arguments pertaining to the pending motions into his amended pleading. Id.

         On January 7, 2019, MetLife filed its opposition [doc. # 26] to plaintiff's motion to compel, in which it argued that, 1) an action for review on an administrative record is exempted from initial disclosure requirements, 2) plaintiff had not issued a formal discovery request to MetLife, and 3) the court has yet to issue its civil case management order requiring MetLife to file a copy of the administrative record. Plaintiff filed his reply brief in support of his motion to compel on January 14, 2019. [doc. # 28]. Therefore, the matter is ripe.

         Analysis

         I. Motion to Dismiss vs. Motion for Summary Judgment

         If evidence outside of the pleadings is presented to the court and used in deciding a 12(b)(6) motion, then the court must convert the matter to a motion for summary judgment. Fed.R.Civ.P. 12(d); Knighton v. Merscorp Inc., 304 Fed.Appx. 285, 287 (5th Cir. 2008) (citing Fernandez-Montes v. Allied Pilots Ass'n, 987 F.2d 278, 283 (5th Cir.1993)). In the matter sub judice, MetLife submitted an affidavit from its litigation specialist, Matthew Hallford, whereby he averred that MetLife never received a request from Trahan for an administrative appeal of its March 28, 2018, claim denial. (Hallford Affidavit). Defendant necessarily relies on this evidence to support its exhaustion argument; therefore, the court must convert the 12(b) motion into a motion for summary judgment. Fed.R.Civ.P. 12(d).

         In the event of conversion, Rule 12(d) requires that all parties be afforded a reasonable opportunity to present all material pertinent to a motion for summary judgment. Id. Specifically, the notice and hearing requirements of Rules 12(b) and 56(c) of the Federal Rules of Civil Procedure must be adhered to. Mackey v. Owens, 1999 WL 423077 (5th Cir. June 2, 1999) (unpubl.).

         The court, however, need not give a party “express notice” that a motion to dismiss will be treated as a motion for summary judgment:

given [Rule 12(d)]'s express declaration that a motion to dismiss shall be treated as a motion for summary judgment where matters outside the pleadings are presented to and not excluded by the court, the simple act of placing matters outside the pleadings before the court provides adequate notice ...

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