A continuing discovery battle in ERISA cases involves the production of claims manuals, internal policies and procedures.
What can you do when a claimant seeks claims manuals, policies and procedures? Seek an agreed protective order.
What if the Plaintiff will not agree to a protective order? Move for a protective order to assure the documents will be used only for this one case.
Why are claims manuals entitled to protection? Courts conclude they are “commercial information” warranting a protective order or confidentiality agreement.
You will want to read this case. Anderson v. Reliance Standard Life Insurance Company [pdf], 2012 WL 835722 (D. Md. March 9, 2012).
Keep it handy because it addresses obtaining protective orders when producing the ERISA Plan and insurers’ claims handling procedures and manuals. It also has great language that can help defeat typical arguments used to oppose motions for protective orders involving the discovery of claims manuals, policies and procedures confidential.
Plaintiff Anderson had a bad back. He sought disability benefits under an ERISA plan with his employer. Reliance Standard was the claims administrator. When his appeal was denied, Anderson sued the Plan and Reliance Standard. During the suit Plaintiff sought discovery from Reliance including: (1) information regarding relationships between the defendants and “various health care providers”; and (2) documents about “internal guidelines, policies, procedures, [and] claims handling manuals.” Discovery matters had been referred to a Magistrate Judge, subject to review by the District Court under a “clearly erroneous” standard of review.
ISSUES/RATIONALE GRANTING PROTECTIVE ORDER:
1. What evidence is required to obtain a protective order?
“A proponent of a protective order must present a particular and specific demonstration of fact that harm will result without a protective order.” Op. at 3
2. Are Claims manuals, policies and procedures entitled to a protective order or a confidentiality agreement? YES
3. Courts should deny discovery requests when the purpose of the discovery is to obtain the documents for use in other lawsuits.
“[W]hen the purpose of a discovery request is to gather information for use in proceedings other than the pending suit, discovery is properly denied.” Op. at 3
“The rules implementing ERISA require Plans to produce internal rules and guidelines to beneficiaries who receive an adverse benefit determination, [but] that requirement governs the case-by-case provision of the documents. The regulations do not require—or support—general public access to internal guidelines.” Op. at 4.
Even though Reliance Standard failed “to make a particularized showing of good cause” for the protective order, “the purpose of the particularized showing is to ensure that the requesting party obtains needed information, not to enable the requesting party to share information with third parties.” Op. at 3.
4. If the Claims Manual is already in the public domain, then “that availability would have been sufficient for [the Judge] to have denied the discovery request.” Op. at 4
5. The fact that other insurers produce their claims manuals without a protective order is irrelevant to whether a protective order should be issued in this case.
“Anderson contends that other insurers have provided their claims manuals without protective orders. Anderson does not explain why another insurer’s choice to make its claims manual public has any bearing on this Court’s determination whether Reliance’s manual contains protection-worthy commercial information.” Op. at 4.
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