CARL E. STEWART, Chief Judge:
Lindsey Green and Brenda Green (collectively "Plaintiffs") appeal the district court's grant of summary judgment in favor of Life Insurance of North America ("LINA") upholding LINA's denial of life insurance benefits to Plaintiffs, beneficiaries of the two policies at issue. Plaintiffs also appeal the modification of a discovery order. We AFFIRM both of these decisions.
Joshua Green ("Green"), husband of Lindsey Green and son of Brenda Green, died while operating a boat on July 16, 2010. Around 8:20 p.m., he called his wife to say he was on his way home. When he did not arrive, she called the police. The Coast Guard found Green in his boat the next morning. He had died because of a head injury sustained when his boat struck the support legs of a landing light at Keesler Air Force Base.
Plaintiffs sought to recover on two Accidental Death and Dismemberment ("AD & D") policies Green held with Life Insurance Company of North America ("LINA") through his employer, Northrop Grumman Corporation. The policies are governed by the Employee Retirement Income Security Act, 29 U.S.C. § 1001, et seq. ("ERISA"). LINA is the issuer, insurer, claims administrator, and plan administrator
The policies included as a "Common Exclusion" from recovery number 8:
LINA initially denied Plaintiffs' claims for three reasons: (1) Green's death was not a "Covered Accident" because he operated a vehicle while intoxicated; (2) Green's death was not a "Covered Accident" because he operated a boat at night without the aid of lights; and, (3) Green was legally intoxicated and the policies excluded recovery for any injury caused by operating a vehicle under the influence of alcohol or drugs. Plaintiffs appealed alleging that LINA: (1) misinterpreted Mississippi and federal law, which required foreseeability to be viewed from the standpoint of the insured; (2) misinterpreted the policy's definition of vehicle; (3) ignored Green's cause of death; and (4) relied on an invalid blood sample. After notifying Plaintiffs that they would require an extension to address Plaintiffs' arguments, LINA denied this appeal nearly three months later. LINA reiterated that Green intentionally operated his boat while intoxicated, making the risk of injury or death substantially certain, foreseeable, and not independent of all causes. Separately, LINA relied on the policies' exclusion of coverage for any accident involving the operation of a vehicle while intoxicated.
On June 3, 2011, Plaintiffs filed suit in federal district court seeking recovery. Throughout the discovery process, LINA was reluctant to provide certain documents. The magistrate judge issued an order compelling discovery but later modified it. The district court affirmed this decision. Both parties filed motions for summary judgment. The district court granted LINA's motion for summary judgment and denied Plaintiffs'. Plaintiffs timely appealed both the modified discovery order and grant of summary judgment to LINA. We address each in turn.
The magistrate judge reconsidered and modified the original discovery order after LINA demonstrated that the order would require a review of 25,000 claims. The modified order required LINA to produce: (1) any policies or procedures which could have been utilized but limited to
We review a district court's decision to limit discovery for abuse of discretion. Crosby v. La. Health Serv. & Indem. Co., 647 F.3d 258, 261 (5th Cir.2011). A district court abuses its broad discretion when its decision is based on an erroneous view of the law, but we will only vacate a court's judgment if it affected the substantial rights of the appellant. Id. The appellant must prove both abuse of discretion and prejudice. Id. We have instructed district courts to "monitor discovery closely" in ERISA cases and to limit discovery if "the burden or expense of the proposed discovery outweighs its likely benefit, considering the needs of the case, ... and [inter alia] the importance of the discovery in resolving the issues." Id. at 264 (internal quotation marks and citations omitted). Given these considerations, we hold that there was no error in modifying this discovery order.
"Standard summary judgment rules control in ERISA cases." Cooper v. Hewlett-Packard Co., 592 F.3d 645, 651 (5th Cir.2009) (internal quotation marks omitted). We review a "district court's grant of summary judgment de novo, applying the same standards as the district court." Id. Summary judgment is appropriate when "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). "When parties file cross-motions for summary judgment, we review each party's motion independently, viewing the evidence and inferences in the light most favorable to the nonmoving party." Duval v. N. Assur. Co. of Am., 722 F.3d 300, 303 (5th Cir.2013) (internal quotation marks omitted).
If the plan gives the administrator discretionary authority to determine eligibility for benefits or to construe the plan's terms, we review a decision to deny benefits only for abuse of discretion. Atkins v. Bert Bell/Pete Rozelle NFL Player Ret. Plan, 694 F.3d 557, 566 (5th Cir. 2012). If there is no such grant of discretion, our review is de novo. Id. "Whether the district court employed the appropriate standard in reviewing an eligibility determination made by an ERISA plan administrator is a question of law" that we review de novo. Ellis v. Liberty Life Assur. Co. of Bos., 394 F.3d 262, 269 (5th Cir.2004). However, "with or without a discretion clause, a district court rejects an administrator's factual determinations in the course of a benefits review only upon the showing of an abuse of discretion." Dutka ex rel. Estate of T.M. v. AIG Life Ins. Co., 573 F.3d 210, 212 (5th Cir. 2009).
Plaintiffs argue that the district court erred when it reviewed LINA's determination for abuse of discretion only. The district court relied on language in the summary plan description ("SPD") to grant LINA discretion to interpret the policy's terms. Plaintiffs argue that this was improper in light of the Supreme Court's decision in CIGNA Corp. v. Amara, ___ U.S. ___, 131 S.Ct. 1866, 179 L.Ed.2d 843 (2011) and our decision in
We need not decide this issue because even under a de novo standard of review Plaintiffs' claims are unavailing. Therefore, we assume without deciding that the standard of review for these policies is de novo.
LINA determined that the circumstances of Green's death were not covered by the policies on two separate grounds: (1) the policies' exclusion precluded coverage for an accident occurring while an insured operated a vehicle while intoxicated; and (2) the accident was not a "Covered Accident" as defined by the policies because it was a foreseeable result of Green's actions. Because we conclude that LINA properly applied the policy exclusion we need not address whether the accident was a "Covered Accident" as defined by the policies.
Plaintiffs argue that this case is identical to Firman and that because LINA applied a per se policy excluding coverage for any death involving alcohol, regardless of any policy exclusions, they should be able to recover. Plaintiffs' argument misses the mark. This case is not identical to Firman. First, Green's plan included an explicit exclusion for alcohol-related deaths whereas the plan in Firman
Plaintiffs next argue that the exclusion is inapplicable because it requires the operation of a "vehicle" while intoxicated and "vehicle" is a term that does not unambiguously include a boat — which is what Green was operating when the accident occurred. Plaintiffs urge that "vehicle" must be defined according to Mississippi law, and because it is ambiguous, it must be construed in favor of Green. Plaintiffs note that under Mississippi law, a vehicle is something that must be used "upon a highway," and therefore, cannot include a boat. See Miss.Code Ann. § 63-3-103(a). Additionally, Plaintiffs assert that Mississippi also clearly distinguishes between "vehicles" and "watercrafts." See Miss. Code Ann. § 63-3-103(b). Finally, Plaintiffs argue that federal law recognizes that a "vessel" is not a "vehicle," and therefore, LINA's conclusion that the exclusion applies is erroneous.
"Federal common law governs rights and obligations stemming from ERISA-regulated plans, including the interpretation" of policy provisions at the heart of this dispute. Provident Life & Accident Ins. Co. v. Sharpless, 364 F.3d 634, 641 (5th Cir.2004).
Mississippi law does not apply to the interpretation of "vehicle" as utilized in Green's policies' exclusion. The exclusion explicitly states that benefits will not be paid "for any Covered Injury or Covered Loss, which, directly or indirectly, in whole or in part, is caused by or results from the following ... operating any type of vehicle while under the influence of alcohol...." The next sentence of this exclusion states: "[u]nder the influence of alcohol, for purposes of this exclusion, means intoxicated, as defined by the law of the state in which the Covered Accident occurred." Contrary to Plaintiffs repeated assertions, this does not mean that Mississippi law applies
We hold that the plain meaning of the word "vehicle" as used in Green's policies is unambiguous and broad enough to encompass a boat. The common and generally accepted meaning of "vehicle" is that it is "a means of carrying or transporting something." See Webster's Third New International Dictionary 2538 (2002);
Plaintiffs are correct that Mississippi and federal law define "vehicle" and "motor vehicle" differently in other contexts.
For the aforementioned reasons, we AFFIRM the district court's grant of summary judgment to LINA and its denial of summary judgment to Plaintiffs. We also AFFIRM the modification of the discovery order.