Milano v. Provident Life & Casualty Insurance Company
- Valerie Caproni
- 1:19-cv-03357
- U.S. District Court · Southern District of New York
- 3
In Milano v. Provident, Judge Caproni denied Milano’s requests to add evidence and obtain discovery beyond the administrative record.
Alfred Milano’s ability to add evidence to the administrative record or obtain discovery beyond that record was limited. The defendants proceeded under the schedule set for their summary-judgment motion.
What happened
In Milano v. Provident Life & Casualty Insurance Company, Alfred Milano asked the court to add recent evidence about his disability to the administrative record in the insurance dispute. He argued that the defendants’ failure to request an independent medical examination was a procedural problem that justified adding the evidence.
The defendants opposed adding the evidence, arguing that Milano had not shown good cause. Milano also asked for discovery to determine whether good cause existed. The opinion states that the parties had agreed that no discovery beyond the administrative record was needed from the defendants.
Judge Valerie Caproni denied both of Milano’s motions. She ruled that the failure to request an independent medical examination was not a procedural deficiency, that the proposed evidence was cumulative, and that Milano had not shown a reasonable chance that discovery would uncover a qualifying procedural problem. The court set deadlines for the defendants’ summary-judgment motion and the parties’ responses.
The detailed version
- Milano v. Provident Life & Casualty Insurance Company · No. 1:19-cv-03357
- Valerie Caproni
- Jan. 13, 2020
Background
Alfred Milano asked the court to supplement the administrative record with recent evidence concerning his disability. The court had requested briefing on whether it should allow that additional evidence. Milano argued that the defendants’ failure to request an independent medical examination was a procedural deficiency that constituted good cause for admitting evidence outside the existing record.
The defendants opposed the request, arguing that Milano had not shown good cause. Milano also moved for discovery to determine whether good cause existed. The parties had agreed in a joint letter that the defendants did not need to provide discovery beyond the administrative record.
Court’s analysis
The court explained that district courts may allow extrinsic evidence—evidence outside the administrative record—when a party shows good cause. Good cause can exist when a plan fails to follow established procedures for evaluating a claim. The court held, however, that the defendants’ failure to request an independent medical examination was not a procedural deficiency. It stated that a plan administrator may choose not to conduct such an examination, particularly when the claimant’s medical evidence on its face does not establish disability.
The court also concluded that Milano’s argument challenged the substance of the defendants’ decision rather than a procedural error in reaching that decision. In addition, the proposed supplemental evidence would be cumulative because Milano acknowledged that it would be consistent with evidence already in the administrative record.
As to discovery, the court held that Milano had not shown a reasonable chance that the requested discovery would reveal a procedural deficiency sufficient to establish good cause. Because his request concerned the substance of the defendants’ decision rather than a procedural failure, the court found that additional discovery was not warranted.
Rulings and next steps
The court denied Milano’s motion to supplement the administrative record. It separately denied Milano’s motion to allow discovery concerning whether good cause existed. The court ordered that the defendants’ motion for summary judgment was due March 6, 2020; Milano’s opposition was due April 3, 2020; and the defendants’ reply was due April 17, 2020. The court also stated that, upon a joint request, it would be willing to refer the parties to Magistrate Judge Cott for a settlement conference.
Read the full 3-page opinion on CourtListener, the free public archive maintained by the Free Law Project.