United States District Court, E.D. Michigan, Southern Division
OPINION AND ORDER DENYING PLAINTIFF'S MOTION FOR
REMAND TO SUPPLEMENT THE ADMINISTRATIVE RECORD (Dkt.
Terrence G. Berg, Judge
Fraley, a former GM engineer who went on disability in April
2012, has brought a lawsuit against GM challenging the denial
of certain benefits pursuant to the Employee Retirement
Income Security Act (“ERISA”). Plaintiff filed
claims with Defendant for company-paid Basic Life Insurance,
company-paid Health Care Coverage, and COBRA Continuation
coverage. Dkt. 8, Pg. ID 3. Defendant allegedly issued a
final denial of Plaintiff's claims on January 11, 2016,
and Plaintiff maintains he has since exhausted his internal
appeals. Dkt. 8, Pg. ID 3. Plaintiff now moves for a remand
to the plan administrator in order to supplement the
administrative record. For the reasons outlined below,
Plaintiff's Motion for Remand to Supplement the
Administrative Record is DENIED.
worked as a GM engineer from September 1997 until April 20,
2012. Dkt. 8, Pg. ID 2. Defendant acknowledges that Plaintiff
was approved for a Total and Permanent Disability Retirement,
which Plaintiff maintains was due to lupus, Reynaud's
syndrome, and chronic obstructive pulmonary disease. Dkt. 4,
Pg. ID 23; Dkt. 1, Pg. ID 2.
Parties disagree on various issues surrounding the type(s) of
coverage to which Plaintiff is entitled and Plaintiff's
coverage history. For the purposes of the motion before the
Court, however, the only issue is whether there is cause to
remand the case to the plan administrator in order to
supplement the record. Dkt. 6.
Standard of Review
reviewing an administrator's decision denying benefits, a
district court conducts a review “based solely on the
administrative record.” Wilkins v. Baptist
Healthcare Sys., Inc., 150 F.3d 609, 610 (6th Cir.
1998). “The only exception to the . . . principle of
not receiving new evidence at the district court level arises
when consideration of that evidence is necessary to resolve
an ERISA claimant's procedural challenge to the
administrator's decision, such as an alleged lack of due
process afforded by the administrator or alleged bias on its
part.” Id. at 618.
Sixth Circuit has found that remand to an ERISA plan
administrator is appropriate in a variety of circumstances
when the plan administrator erroneously denies benefits,
particularly where the plan administrator's decision
suffers from a procedural defect or the administrative record
is factually incomplete. See Shelby County Health Care
Corp. v. Majestic Star Casino, 581 F.3d 355, 373 (6th
Cir. 2009) (internal citations omitted). However, with regard
to alleged factually incomplete administrative records, the
Sixth Circuit has noted that a complainant “cannot
‘simply on a hunch' compel [Defendant] to produce
documents that either do not exist or were not included in
the administrative record in the ordinary course of
[Defendant's] business.” Likas v. Life Ins. Co.
of North America, 222 Fed.Appx. 481, 485 (6th Cir. 2007)
(unpublished case) (internal citations omitted).
motion “contends the administrative record is
incomplete with respect to various important records”
and “requests the Court order a remand to the
administrator to supplement the administrative record.”
Dkt. 8, Pg. ID 1035, 1036. However, neither Plaintiff's
original Complaint nor his motion to remand raises a claim of
administrator bias or a claim of procedural deficiency during
the underlying administrative proceeding. See Dkts.
1, 8. Moreover, Plaintiff does not argue that the
administrative record filed by Defendant in this action, Dkt.
6, is an inaccurate or incomplete representation of the
record evidence that was reviewed by the plan administrator
in the underlying proceeding.
the motion argues that “[i]n the experience of
plaintiff's attorney, and probably in the court's
experience” administrative records in ERISA cases like
this “routinely” contain evidence that is not
present in the administrative record filed by Defendant here.
Dkt. 8, Pg. ID 1042. Plaintiff maintains that certain
“ordinary and important records” such as
“telephone records and logs of conversations with the
claimant, ” are normally included but that here,
“the administrative record has no documentation of any
telephone communications . . . [and further that t]he
administrative record has no written indication that
plaintiff's COBRA claim was denied.” Id.
at 1041, 1042.
reply, Defendant argues there is no basis to allow discovery
or to remand to the plan administrator for consideration of
additional evidence. Dkt. 12, Pg. ID 1060. Because
Plaintiff's Complaint (Dkt. 1) and Motion to Remand (Dkt.
8) do not raise a claim of administrator bias or procedural
deficiency, they do not require remand to the plan
administrator to consider additional evidence. Dkt 12, Pg. ID
1061-62; see also Wilkins, 150 F.3d at 610.
Defendant's position is correct. Because Plaintiff's
complaint does not allege facts amounting to a denial of
procedural due process in connection with the plan
administrator's decision, the Court finds that its review
in this matter may be correctly based solely on the
administrative record, and remand to the administrator for
the consideration of additional evidence is not warranted.
See Wilkins, 150 F.3d at 610; see also Fendler
v. CAN Group Life Assur. Co., 247 Fed.Appx. 754, 757-58
(6th Cir. 2007) (unpublished case) (denying a plaintiff's
request to supplement the administrative record, in part, for
plaintiff's failure to assert a procedural challenge to
the administrator's decision in his complaint).
Plaintiff's claim that remand is necessary because the
administrative record is allegedly incomplete, Defendant
argues, “[p]laintiff's belief that the filed
administrative record is incomplete has no factual support.
Defendant cannot supplement the administrative records with
documents or materials that do not exist or were not
maintained by Defendant in its ordinary course of
business.” Dkt. 12, Pg. ID 1063 (citing Likas,
222 Fed.Appx. at 485 (unpublished case)). While
Plaintiff's counsel suggests that certain kinds of
evidence are normally found in other ERISA administrative
records, Plaintiff has ...