United States District Court, E.D. California
MEMORANDUM AND ORDER
MORRISON C. ENGLAND, JR. UNITED STATES DISTRICT JUDGE
action, Plaintiff Loretta Bruce (“Plaintiff”)
seeks redress under various California laws from Defendant
Hartford Life and Accident Insurance Company
(“Defendant”) arising from Defendant's
termination of Plaintiff's long-term disability
(“LTD”) benefits. Presently before the Court are
Defendant's Motion for Summary Adjudication and
Plaintiff's Motion for Partial Summary Judgment pursuant
to Federal Rule of Civil Procedure 56, as well as
Defendant's Motion to File Sur-reply and Motion to
Strike. The matter is fully briefed, and for the reasons
outlined below Defendant's Motion for Summary
Adjudication (ECF No. 47) is GRANTED, Plaintiff's Motion
for Partial Summary Judgment (ECF No. 48) is DENIED, and
Defendant's Motion to File Sur-reply (ECF No. 82) and
Motion to Strike (ECF No. 63) are DENIED as
issued Group Contract Number GLT-677969 (the
“Policy”) to Los Rios Community College District
(“Los Rios”), effective July 1, 2010, for Los
Rios employees. Pl.'s Compl., ECF No. 1 ¶ 7.
Plaintiff, as a Los Rios employee, was a beneficiary of the
Policy. Id. ¶¶ 6-8. On February 11, 2016,
Plaintiff sustained an injury after falling at work. She
subsequently underwent surgery for a meniscus tear, and she
still experiences continuous pain and swelling in her knee.
Id. ¶ 13. As a result, according to Plaintiff,
she became disabled from her job as a Center Lead Pre-School
relevant part, the applicable Policy provides coverage for
injuries in the event of disability, as follows:
[D]uring the Elimination Period and for the next 24 month(s),
as a result of injury or sickness, You are unable to perform
with reasonable continuity the Essential Duties necessary to
pursue Your occupation in the usual and customary way. After
that, as a result of injury or sickness You are unable to
engage with reasonable continuity in Any Occupation.
Id. ¶ 9 (emphasis added).
Plaintiff applied for LTD benefits (“Your
Occupation” benefits) from Defendant in March 2016
after her employer determined she could no longer perform her
occupation and could not be accommodated to do so.
Id. ¶ 15. On April 27, 2016, Defendant granted
Plaintiff's claim for Your Occupation benefits, effective
for a two-year period retroactive to January 11, 2016, but
also referred Plaintiff's claim to Defendant's
special investigation unit (“SIU”) for further
investigation. Id. ¶ 16; Def.'s Mem. Supp.
Summ. Adj., ECF No. 47 at 5:9-11.
thereafter conducted surveillance of Plaintiff, during which
she was observed driving, pumping gas, running errands,
carrying items weighing less than approximately twenty
pounds, and standing and walking for about twenty to thirty
minutes at a time, with sit-down breaks and/or driving in
between. Pl.'s Compl. ¶ 19. Plaintiff was also seen
performing activities such as ascending and descending two or
three steps, adjusting a hose, and sweeping. Id.
Defendant's field investigators interviewed Plaintiff,
and again her claim was referred to the SIU to clarify
[Plaintiff's] current restrictions/limitations and her
ability to perform her occupation. Id. ¶¶
22-23. Defendant also conducted an occupational analysis and
arranged for Plaintiff to attend an Independent Medical
Evaluation (“IME”), which she did. Id.
¶¶ 24, 27-28. The attending doctor, Dr. Bernhard,
concluded that Plaintiff was able to walk forty minutes at a
time for a total of three hours per day, lift twenty pounds
for five minutes continuously per hour, carry fifteen pounds
up to five minutes per hour for a total of eight hours per
day, and push and pull fifty pounds for ten minutes per hour
for a total of eight hours per day. Id. ¶ 28.
November 21, 2016, Defendant terminated Plaintiff's Your
Occupation benefits by letter. Id. ¶ 31;
Def.'s UMF, ECF No. 70-2 at 47:15-23. The letter set out
Dr. Bernhard's conclusions from the IME and noted that,
although Plaintiff's treating doctor, Dr. Coward,
somewhat disagreed with Dr. Bernhard's conclusions, Dr.
Coward did not believe they had any major differences of
opinion. Def.'s UMF at 47:15-23. Therefore, Defendant
concluded Plaintiff was able to perform the Essential Duties
of her occupation. Id. Approximately six months
later, with the assistance of counsel, Plaintiff appealed the
termination of those benefits. Pl.'s Compl. ¶¶
36, 38; Def.'s UMF at 47:24-27.
receiving Plaintiff's appeal, Defendant requested an
independent peer review of Plaintiff's medical file by
Dr. Pietro Seni. Def.'s UMF at 50:16-18. Because Dr. Seni
ultimately agreed with Dr. Coward on Plaintiff's
restrictions and limitations, Defendant reversed its initial
termination and reinstated Plaintiff's Your Occupation
benefits. Id. at 50:18-51:6.
Defendant conducted an Employability Analysis Report
(“EAR”) using the restrictions and limitations
determined by Dr. Seni and other relevant information.
Id. at 51:28-52:3. Based on those results, by letter
dated August 29, 2017, Defendant prospectively terminated
Plaintiff's future LTD benefits effective January 10,
2018, at which point Plaintiff had to meet the Policy's
Any Occupation standard (“Any Occupation”
benefits). Id. at 71:21-72:5. Defendant notified
Plaintiff of the opportunity to appeal; however, Plaintiff,
determining an appeal would be futile, initiated this action
instead. Id. at 71:21-72:5; Pl.'s Compl. ¶
Federal Rules of Civil Procedure provide for summary judgment
when “the movant shows that there is no genuine dispute
as to any material fact and the movant is entitled to
judgment as a matter of law.” Fed.R.Civ.P. 56(a);
see also Celotex Corp. v. Catrett, 477 U.S. 317, 322
(1986). One of the principal purposes of Rule 56 is to
dispose of factually unsupported claims or defenses.
Celotex, 477 U.S. at 325.
also allows a court to grant summary judgment on part of a
claim or defense, known as partial summary judgment.
See Fed.R.Civ.P. 56(a) (“A party may move for
summary judgment, identifying each claim or defense-or the
part of each claim or defense-on which summary judgment is
sought.”); see also Allstate Ins. Co. v.
Madan, 889 F.Supp. 374, 378-79 (C.D. Cal. 1995). The
standard that applies to a motion for partial summary
judgment is the same as that which applies to a motion for
summary judgment. See Fed.R.Civ.P. 56(a); State
of Cal. ex rel. Cal. Dep't of Toxic Substances Control v.
Campbell, 138 F.3d 772, 780 (9th Cir. 1998) (applying
summary judgment standard to motion for summary
summary judgment motion, the moving party always bears the
initial responsibility of informing the court of the basis
for the motion and identifying the portions in the record
“which it believes demonstrate the absence of a genuine
issue of material fact.” Celotex, 477 U.S. at
323. If the moving party meets its initial responsibility,
the burden then shifts to the opposing party to establish
that a genuine issue as to any material fact actually does
exist. Matsushita Elec. Indus. Co. v. Zenith
Radio Corp., 475 U.S. 574, 586-87 (1986); First
Nat'l Bank v. Cities Serv. Co., 391 U.S. 253, 288-89
attempting to establish the existence or non-existence of a
genuine factual dispute, the party must support its assertion
by “citing to particular parts of materials in the
record, including depositions, documents, electronically
stored information, affidavits[, ] or declarations . . . or
other materials; or showing that the materials cited do not
establish the absence or presence of a genuine dispute, or
that an adverse party cannot produce admissible evidence to
support the fact.” Fed.R.Civ.P. 56(c)(1). The opposing
party must demonstrate that the fact in contention is
material, i.e., a fact that might affect the outcome of the
suit under the governing law. Anderson v. Liberty Lobby,
Inc., 477 U.S. 242, 248, 251-52 (1986); Owens v.
Local No. 169, Assoc. of W. Pulp and Paper Workers, 971
F.2d 347, 355 (9th Cir. 1987). The opposing party must also
demonstrate that the dispute about a material fact “is
‘genuine,' that is, if the evidence is such that a
reasonable jury could return a verdict for the nonmoving
party.” Anderson, 477 U.S. at 248. In other
words, the judge needs to answer the preliminary question
before the evidence is left to the jury of “not whether
there is literally no evidence, but whether there is any upon
which a jury could properly proceed to find a verdict for the
party producing it, upon whom the onus of proof is
imposed.” Anderson, 477 U.S. at 251 (quoting
Improvement Co. v. Munson, 81 U.S. 442, 448 (1871))
(emphasis in original). As the Supreme Court explained,