Plastic and Reconstructive Breast Surgery PLLLC v. Cigna Health and Life…

Background

Plastic and Reconstructive Breast Surgery PLLLC and Shareef Jandali Plastic Surgery LLC, individually and as assignees of Patient J.B., asked to reopen discovery and obtain limited information beyond the administrative record. They sought discovery about a stop-loss policy that Geissler’s Supermarket, Inc. obtained from Cigna Health and Life Insurance Company for the plan involved in the case.

The plaintiffs said they did not have basic information about the policy’s attachment point—the amount above which Cigna would be financially responsible for benefit payments—including whether that amount had been reached and how much coverage might remain. They argued that this information could show whether Cigna had a structural conflict of interest. The defendants argued that the plaintiffs had known about the policy since at least February 28, 2022, had not properly alleged a conflict, and had not shown good cause to reopen discovery.

Court’s Analysis

Judge Wang found good cause under Federal Rule of Civil Procedure 16(b)(4) to reopen discovery. The court reasoned that Cigna had not clarified whether it was financially responsible for the claims, and that the plaintiffs had represented that they did not learn Cigna might be financially responsible until after discovery closed. The court concluded that additional discovery could produce relevant evidence about an alleged conflict of interest and that a fair and accurate review required clarity about Cigna’s possible financial responsibility.

The court also found that the plaintiffs could not determine whether the stop-loss policy was relevant or admissible without obtaining a copy. It further found that limited additional discovery would not cause serious prejudice to Cigna.

Order

The court GRANTED the plaintiffs’ request to reopen discovery. The plaintiffs may serve written requests for production and take a limited deposition under Rule 30(b)(6) of Cigna’s corporate representative on the specific topics identified in ECF 48. The court extended the fact-discovery deadline to July 7, 2023, and directed the Clerk of Court to close ECF 48.