Rarely does the U.S. Court of Appeals for the Fifth Circuit admonish a federal judge for particular practices, at least in a published opinion, but then it is rare that a federal judge ignores explicit Fifth Circuit instructions regarding the appropriate standard to apply in a particular kind of a case. Both those rare events occurred in McCorkle v. Metropolitan Life Insurance Co., No. 13-30745, an opinion issued on July 3, 2014.
In McCorkle, a widow claimed that her husband had not committed suicide even though “he owned, loaded, placed under his chin, and fired” a .45 caliber revolver. Since the husband was taking Lunesta at the time of his death, the widow claimed he’d been out of his mind and did not have the requisite intent for suicide, despite the parish coroner’s conclusion in the death certificate that the cause of death was suicide. MetLife was the administrator of the husband’s ERISA-governed employee welfare plan. When MetLife refused accidental death benefits because it determined that her husband’s death was not an accident, the widow first made unsuccessful administrative appeals and then filed suit in U.S. District Court for the Middle District of Louisiana. So far, an unexceptional case. Then the district court, on cross motions for summary judgment, entered judgment for the widow, awarded her full benefits under the Plan, as well as attorney’s fees, costs, and interest. The court concluded on the record, but not in a written opinion, that the husband “was under the control of Lunesta and not [acting] of his own free will or volition.” Further, the court stated in oral argument but not in a written opinion, that “Lunesta caused [the husband’s] death,” and the drug “took away [the husband’s]understanding that this was self-destruction.”
MetLife appealed. Now we’ll let the Fifth Circuit panel of Judges Smith, Wiener, and Prado speak for itself. First, the Court appeared annoyed with the district judge for failing to put its reasoning – presumably the reasoning stated on the record – into an opinion: "Consistent with his recent practice, this district judge from the Western District of Louisiana, sitting by designation in the Middle District, did not favor us or the parties with written reasons." [Op. at 5, fn. 3.]
Next, the Court took issue with it what it considered repeated conduct by the district judge in failing to understand its role in a case of this kind:
It apparently bears repeating here that district courts hearing complaints from disappointed ERISA plan members or their beneficiaries for the administrative denial of benefits are not sitting, as they usually are, as courts of first impression. Rather, they are serving in an appellate role. And, their latitude in that capacity is very narrowly restricted by ERISA and its regulations, as interpreted by the courts of appeals and the Supreme Court, including the oft-repeated admonition to affirm the determination of the plan administrator unless it is “arbitrary” or is not supported by at least “substantial evidence”—even if that determination is not supported by at least “substantial evidence”—even if that determination is not supported by a preponderance. We had thought that by now this was understood and accepted by all district judges of this circuit. But, as this case demonstrates that we were wrong, at least as to one of them, we try yet again to drive that message home.
[Op. 6-7. Footnotes omitted. Emphasis added.]
Warmed up, as it were, the Court then weighed in on the district judge’s refusal “yet again” to accord plan fiduciaries with the discretion to interpret plan ambiguities, a rule the Court felt was well-established precedent:
The district judge also disregarded the rule that, when an ERISA plan vests a fiduciary with discretion to interpret plan terms, the fiduciary “has the power to resolve ambiguities.” The question for any reviewing court “is not whether the interpretation of the Plan ‘is most persuasive, but whether the plan administrator’s interpretation is unreasonable.’ ” By relying on nothing other than Black’s Law Dictionary for the definition of suicide and then weighing the record evidence de novo instead of reviewing it for substantial evidence and thus reasonableness, this district judge yet again, as he did in Smith, “turned the deference afforded to plan administrators flatly on its head.” Moreover, in so doing, he repeated conduct we had condemned previously when he “finely pars[ed] the plan’s language without paying any heed, save lip-service, for the discretion that was reasonably exercised by [MetLife] when interpreting” the term “suicide.” As he had in Smith, this judge erred by “substituting [his] own, narrower interpretation of the term [“suicide”] in place of [MetLife’s] reasonable, yet broader, interpretation.” And he expressly confirmed that he did so in full awareness that he was proceeding in violation of established circuit law, stating on the record at the oral argument hearing of this case: “I know how the Fifth Circuit feels about this, and I may get reversed again.”
We have repeatedly emphasized that the standard of review the district courts—and this court, for that matter—must apply in these ERISA cases is the deferential abuse of discretion standard.
(Op. 10-11. Footnotes omitted. Emphasis added.)
Then, in a footnote, the Court quoted the district court’s discussion of the definition of “suicide” alluded to in the text of the opinion:
I continue to be perplexed as to why some of these—if not most—policies for life insurance don’t define suicide, since it is an actual exclusion, so that people would know what is meant by suicide. . . . So we looked up the Black’s Law Dictionary definition of suicide, and it states . . . : [“]Suicide is the willful and voluntary act of a person who understands the physical nature of the act and intends by it to accomplish the results of self-destruction.[”] That’s pretty clear. That’s not confusing. So if this lady, widow, was denied the extra insurance that was paid for by her husband because it was suicide, then someone has the obligation of putting into the policy itself what suicide is.
[Op. at 10, fn. 19.]
Finally, the Court saved some of its most pungent language for the last:
[The husband’s] death under the circumstances of this case is indeed tragic. Distressing facts, however, do not relieve the district court of its duty to uphold a plan administrator’s benefits determination when, as here, it falls “somewhere on a continuum of reasonableness.” Although, by his own words, the district judge “kn[ew] how the Fifth Circuit feels about this,” he deliberately ignored our previous instructions by selecting—in his words—the “more reasonable” of two reasonable conclusions, Loy’s over MetLife’s. Regrettably, we must take this opportunity to remind him and all district courts of this circuit that the reviewer may never substitute its judgment for the reasonable judgment of the plan administrator when it is grounded in substantial evidence.
[Op. at 12. Emphasis added.]
Although probably an optical allusion, the all caps REVERSED and RENDERED following the conclusion seemed especially stern. The law announced in the opinion is unexceptional. The pointed comments aimed at the district judge were unusual enough to capture mention in the Fifth Circuit Civil News on August 21.