Caprio v. Bell Atl Sickness ( 2004 )


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  •                                                                                                                            Opinions of the United
    2004 Decisions                                                                                                             States Court of Appeals
    for the Third Circuit
    7-8-2004
    Caprio v. Bell Atl Sickness
    Precedential or Non-Precedential: Precedential
    Docket No. 03-2253
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    Recommended Citation
    "Caprio v. Bell Atl Sickness" (2004). 2004 Decisions. Paper 442.
    http://digitalcommons.law.villanova.edu/thirdcircuit_2004/442
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    PRECEDENTIAL              Attorney for Appellant
    UNITED STATES COURT OF
    APPEALS                         Steven D. Spencer
    FOR THE THIRD CIRCUIT                 Kay Kyungsun Yu
    Morgan, Lewis & Bockius
    1701 Market Street
    No. 03-2253                   Philadelphia, Pa. 19103
    Attorneys for Appellees
    FRANK J. CAPRIO,                     Verizon Communications
    Inc. and Bell Atlantic Sickness
    Appellant          and Accident Disability
    v.                         Benefit Plan
    BELL ATLANTIC SICKNESS                   Douglas E. Ress
    AND ACCIDENT PLAN; CORE, INC.;             Kaufman, Coren, Ress & Weidman
    VERIZON, INC.                      1525 Locust Street
    17th Floor
    Philadelphia, Pa. 19102
    On Appeal from the United States
    District Court                James T. Finnigan
    for the Eastern District of Pennsylvania   Rich May
    (D.C. Civ. No. 00-cv-06155)          176 Federal Street
    Honorable R. Barclay Surrick,         Boston, MA 02110
    District Judge
    Attorneys for Appellee CORE, Inc.
    Submitted under Third Circuit
    LAR 34.1(a) June 28, 2004                   OPINION OF THE COURT
    BEFORE: AMBRO, BECKER, and
    GREENBERG, Circuit Judges
    GREENBERG, Circuit Judge.
    (Filed: July 8, 2004)
    I. INTRODUCTION
    William T. Wilson                                 This matter comes on before this
    MacElree Harvey Ltd                        court on an appeal brought by Frank J.
    17 West Miner Street                       Caprio from orders entered in the district
    P.O. Box 660                               court on April 1, 2003, granting a motion
    West Chester, PA 19381                     for summary judgment made by
    defendants Bell Atlantic Sickness and            includes administrative appeal
    Accident Plan (“Plan”), Verizon, Inc.            procedures. Inasmuch as Caprio was
    (“Verizon”) and CORE, Inc. (“CORE”)              awarded benefits based on sickness but
    (“appellees”), denying Caprio’s motion           denied more generous accident benefits,
    for summary judgment, and entering               he seeks in this action to recover accident
    judgment in favor of the appellees. We           benefits.
    will vacate the orders and will remand
    the case to the district court for further               After certain proceedings in the
    proceedings.                                     district court that we need not describe,
    appellees moved for summary judgment,
    The background of the case is as         but the court denied their motion without
    follows. Caprio, who claimed to be               prejudice in a memorandum opinion on
    disabled and who had been employed by            May 31, 2002. The court, largely
    Bell Atlantic Company of Pennsylvania            concerning its opinion with determining
    and later by its successor, Verizon,             its standard of review under Firestone
    brought this action against appellees            Tire & Rubber Co. v. Bruch, 489 U.S.
    under ERISA, 29 U.S.C. § 1001 et seq.,           101, 
    109 S. Ct. 948
    (1989), concluded
    seeking benefits under a Sickness and            that it would examine the denial of
    Accident Disability Benefit Plan that            benefits under an arbitrary and capricious
    Bell Atlantic and Verizon provided.1             standard of review. The district court
    Caprio made CORE a defendant because             then considered our opinion in Pinto v.
    it had administrative and fiduciary              Reliance Standard Life Insurance Co.,
    responsibilities under the Plan and made         
    214 F.3d 377
    , 387 (3d Cir. 2000),
    determinations regarding claimants’              quoting it for the point that “heightened
    eligibility for payments, including              scrutiny is required when an insurance
    determinations with respect to Caprio.           company is both plan administrator and
    The Plan makes a distinction between             funder.” The district court later in its
    disabilities attributable to sickness and        opinion cited Goldstein v. Johnson &
    those attributable to accidents and              Johnson, 
    251 F.3d 433
    , 442 (3d Cir.
    2001), concluding from that case that
    Pinto “does not appear to be limited to
    1                                              plans involving insurance companies.”
    Even though Caprio sued Verizon,
    Inc. appellees indicate that there is no
    The district court noted that
    such entity and that Verizon
    appellees had submitted an affidavit
    Pennsylvania, Inc., a subsidiary of
    stating that CORE’s compensation was
    Verizon Communications Inc., was
    “not tied in any way to the results of the
    Caprio’s employer. Appellees indicate
    disability cases that it manages for Bell
    that Caprio also misnamed the defendant
    Atlantic.” This representation led the
    Plan. These mistakes may be rectified on
    court to observe that, according to the
    remand by appropriate amendments.
    2
    affidavit, “CORE has no conflict of                      disability benefits. The
    interest in administering claims under the               District Court’s decision
    Plan.” Nevertheless, inasmuch as the                     that CORE did not abuse
    court believed that Caprio was entitled to               its discretion in denying
    answers to interrogatories he had served                 Caprio’s appeals
    before it definitively settled on its                    concerning the
    standard of review, it denied appellees’                 classification of his [short
    motion without prejudice and ordered                     term disability] benefits
    them to answer Caprio’s interrogatories                  was also correct.
    “for the limited purpose of determining
    the appropriate standard of review in this        
    Id. at 11.
    case.” Not inappropriately, the court did
    not indicate what its result would be on                 In fact, notwithstanding the
    the merits depending on the standard of           foregoing statement, the court did not
    review it selected.                               indicate, following the appellees’
    renewal of their motion for summary
    The appellees apparently                  judgment, exactly what standard of
    answered the interrogatories as in their          review it was using, though it had
    brief they indicate, in a representation          considered this point preliminarily in its
    that Caprio does not contradict, that after       May 31, 2002 opinion. Moreover, it
    “some discovery had been completed,”              never said at any time that CORE “did
    appellees br. at 3, appellees renewed             not abuse its discretion in denying
    their motion for summary judgment and             Caprio’s appeals . . . .” Indeed, as
    Caprio moved for summary judgment.                appellees acknowledge, the court did not
    Appellees then indicate that the district         render any opinion when it granted
    court, “without opinion, allowed the              summary judgment. Rather, it simply
    motion of the defendants-appellees and            entered orders granting appellees’
    denied Caprio’s motion.” 
    Id. at 4.
    The            motion, denying Caprio’s motion, and
    appellees in their brief go on to explain:        granting a judgment in favor of the
    appellees, following which Caprio
    The District Court                  appealed. We have jurisdiction under 28
    correctly held that CORE’s                 U.S.C. § 1291.
    decision must be reviewed
    under the arbitrary and
    capricious standard
    because the [Plan] confers                              II. DISCUSSION
    upon CORE the
    discretionary authority to                        Inasmuch as the district court did
    resolve all questions                      not indicate why it was granting the
    relating to eligibility for                appellees’ motion for summary
    3
    judgment, it did not act in conformity             that court for further proceedings. In
    with our direction in Vadino v. A. Valey           those proceedings the court may revisit
    Engineers, 
    903 F.3d 253
    , 259 (3d Cir.              its substantive decision granting
    1990), to district courts in this circuit to       appellees summary judgment if it
    “accompany grants of summary                       concludes that it would be appropriate to
    judgment . . . with an explanation                 do so.
    sufficient to permit the parties and this
    court to understand the legal premise for                  We regret that the consequence of
    the court’s order.” See also Forbes v.             our disposition is to put the parties to
    Township of Lower Merion, 313 F.3d                 additional expense which they fairly may
    144, 148-49 (3d Cir. 2002). Even though            attribute to the district court’s failure to
    our standard of review is plenary with             conform to our directions in Vadino.
    respect to the order of the district court,        Accordingly, in order that the procedural
    see Kemmerer v. ICI Americas Inc., 70              oversight here not be replicated, we point
    F.3d 281, 286 (3d Cir. 1995), and thus             out that in future cases in which district
    we could determine this matter on the              courts overlook the procedure we set
    merits without remanding, see Vadino,              forth in Vadino the parties should 
    not 903 F.2d at 259-60
    , we are satisfied that          hesitate to bring that case to the court’s
    the uncertainties surrounding the court’s          attention.
    order in this complex matter, both as to
    the standard of review it exercised and                    We make this suggestion even
    the basis for its assessment of Caprio’s           though we can understand why parties
    claim on the merits, require that, in the          might be wary of advising a district court
    first instance, the district court explain         of its oversight, and we do not require
    the reasons for its decision. See Gillis v.        that they do so. Yet we note that our
    Hoechst Celanese Corp., 
    4 F.3d 1137
    ,               suggestion is consistent with
    1149 (3d Cir. 1993).                               requirements in other situations that
    parties bring procedural requirements to
    The fact is that we are not certain         a court’s attention if it should overlook
    whether the district court granted                 them. Thus, Federal Rule of Civil
    summary judgment for appellees through             Procedure 24(c) provides that when the
    the application of Firestone with or               constitutionality of any act of Congress
    without our refinement of that case in             or statute of a State affecting the public
    Pinto. Moreover, whatever standard the             interest is drawn in question in an action
    court followed, we do not know the                 in which the United States or the State or
    reasoning that led it to grant the                 any agency, officer, or employee thereof
    appellees’ motion for summary                      is not a party, the court shall notify the
    judgment. Thus, we will vacate the                 Attorney General of the United States or
    orders of the district court entered on            the State’s attorney general, depending
    April 1, 2003, and remand the case to              upon the statute implicated, as provided
    4
    by 28 U.S.C. § 2403, so that he or she             determined, however, not to retain
    may intervene on the question of                   jurisdiction because we have authorized
    constitutionality. It further provides that        the court to revisit its decision on the
    the party challenging the constitutionality        merits and thus it is conceivable that the
    of the legislation “should call the                court’s outcome on remand could be
    attention of the court to its consequential        different from that which it reached
    duty.” Similarly, under some case law              previously. Moreover, it is possible that
    when a party following trial moves for             the disappointed party, after considering
    judgment as a matter of law and, in the            the court’s explanation for its
    alternative, moves for a new trial, it             determination, may not wish to pursue
    should notify the court of the need for it         the matter further.2
    to make a contingent ruling on the
    motion for a new trial if it grants the
    judgment as a matter of law but does not
    rule on the motion for a new trial. See                       III. CONCLUSION
    Lowenstein v. Pepsi-Cola Bottling Co. of
    Pennsauken, 
    536 F.2d 9
    , 12 n.8 (3d Cir.                   For the foregoing reasons we will
    1976); Arenson v. Southern Univ. Law               vacate the orders of the district court
    Ctr., 
    43 F.3d 194
    , 196 (5th Cir. 1995).            entered on April 1, 2003, and will
    Indeed, if the party does not notify the           remand the matter to that court for
    court of this procedural requirement it            further proceedings. The parties will
    may lose the possibility of obtaining a            bear their own costs on this appeal.
    new trial if the judgment as a matter of
    law in its favor is reversed. See
    
    Lowenstein, 536 F.2d at 12
    n.8.
    In closing we point out that we
    have not overlooked our authority to
    retain jurisdiction as we did in Forbes
    after we remanded that case to the
    district court to specify the material facts
    in issue which precluded the court from
    granting the defendants’ motion for
    summary judgment in a 42 U.S.C. § 1983               2
    Of course, if the court does not grant
    action on the basis of qualified immunity.
    a summary judgment on the remand it is
    
    Forbes, 313 F.3d at 151
    . If we retained
    unlikely that the order denying summary
    jurisdiction, we then could determine the
    judgment will be appealable, at least
    matter without a new appeal being filed
    before a final judgment is entered. See
    following the remand, perhaps after
    In re Complaint of PMD Enters., Inc.,
    additional briefing. We have
    
    301 F.3d 147
    , 149 (3d Cir. 2002).
    5