Delande v. ING Employee Benefits

Opinions of the United
2004 Decisions States Court of Appeals
for the Third Circuit
10-19-2004
Delande v. ING Empl Benefits
Precedential or Non-Precedential: Non-Precedential
Docket No. 02-3737
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"Delande v. ING Empl Benefits" (2004). 2004 Decisions. Paper 220.
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NOT PRECEDENTIAL
UNITED STATES COURT OF APPEALS
FOR THE THIRD CIRCUIT
No: 02-3737
BRIDGET DELANDE,
Appellant
v.
ING EMPLOYEE BENEFITS; RELIASTAR
LIFE INSURANCE COMPANY; ABC CORPORATION,
and JOHN DOES 1-10 (said names being fictitious)
Appeal from the United States District Court
for the District of New Jersey
(Civ. No. 01-cv-03682)
District Judge: Garrett E. Brown, Jr.
Submitted Under Third Circuit LAR 34.1(a)
September 20, 2004
Before: McKEE, ROSENN and WEIS, Circuit Judges
(Opinion filed: October 19, 2004)
OPINION
McKEE, Circuit Judge:
Bridget Delande seeks review of the district court’s grant of summary judgment in
favor of ReliaStar Life Insurance Company. Because we find that ReliaStar’s benefit
determination was not arbitrary and capricious, and there is no genuine issue of material
fact, we affirm the grant of summary judgment.
I.
Delande was a customer service representative for MicroWarehouse. ReliaStar
administers the disability plan for M icro Warehouse and approved long term disability
benefits for Delande when she was injured in a car accident on July 18, 1999. After
conventional treatment proved to be ineffective for her back injuries, Delande underwent
surgery to correct a herniated disc and degenerative disc disease. In the months following
the surgery, Delande’s physician, Dr. Dhawlikar, evaluated her recovery during follow-up
appointments. ReliaStar considered those medical evaluations in determining Delande’s
continued eligibility for disability benefits.
In January 2001, an independent physician also reviewed Delande’s medical
records and determined that Delande was no longer “disabled,” A. 148. “Disabled” is
defined under the Plan as being “unable to do the essential duties of your own occupation,
due to sickness or accidental injury.” A. 110. Thereafter, ReliaStar notified Delande that
her benefits would be terminated. A.149. Delande appealed the decision according to the
terms of the Plan and upon a final adverse determination by ReliaStar, she filed the
instant suit in district court.
The district court granted ReliaStar’s motion for summary judgment using a
heightened form of the arbitrary and capricious standard. The court concluded that
ReliaStar gave her claim full and fair review but accepted the contrary medical findings
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of her own physician. The court also concluded that ReliaStar was not under any
obligation to provide an independent medical examination. A.11.
II.
We have jurisdiction pursuant to 28 U.S.C. §1291. We exercise plenary review
over the grant of summary judgment and review the facts in the light most favorable to
the party against whom summary judgment was entered. Pi Lambda Phi Fraternity, Inc.
v. University of Pittsburgh, 229 F.3d 435, 441 (3d. Cir. 2000). Summary judgment is
appropriate when no genuine issue of material fact exists and the moving party is
therefore entitled to judgment as a matter of law. Thus, the moving party is entitled to
summary judgment when the record, taken as a whole, could not lead a rational trier of
fact to find for the non-moving party or where the facts are not disputed and there is no
genuine issue for trial. Matsushita Electrical Indus. Co. Ltd v. Zenith, 475 U.S. 574, 586-
97.
III.
ReliaStar’s plan is governed by ERISA. 29 U.S.C. § 1132(a)(1)(B). The Plan
gives ReliaStar final discretionary authority to interpret its terms and determine benefit
eligibility. Accordingly, we review ReliaStar’s decision under an arbitrary and capricious
standard. Firestone Tire and Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989). This
standard of review is subject to a “sliding scale” because ReliaStar both funds and
administers the benefits. Under the “sliding scale” a court should consider the nature and
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degree of apparent conflicts of interests when reviewing under the arbitrary and
capricious standard. Pinto v. Reliance Standard Life Ins. Co. 214 F.3d 377, 393 (3d. Cir.
2000). We review the evidence that was before the administrator when it made the
decision and the decision will only be overturned if it is “without reason, unsupported by
the evidence or erroneous as a matter of law.” Abnathya v. Hoffman-LaRoche, Inc., 2
F.3d 40, 45 (3d Cir. 1993) (internal quotations and citations omitted). See also Mitchell v.
Eastman Kodak Co., 113 F.3d 433, 440 (3d.Cir. 1997).
The district court carefully reviewed the record as explained in the court’s oral
decision delivered on September 3, 2002. App 6-13. The court explained that ReliaStar’s
decision was based upon a lack of objective evidence regarding Delande’s ongoing
disability. We agree, and we will not substitute our judgment for the that of the Plan
administrator. The decision to terminate Delande’s long term disability benefits was not
arbitrary and capricious and we will therefore affirm the district court’s grant of summary
judgment.
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