JOHN F. GRADY, District Judge.
Before the court is the motion to compel of plaintiff Kenneth M. Krase as Special Administrator for the Estate of Donald Krase ("Krase"). For the reasons explained below, we grant Krase's motion.
We will assume that the reader is familiar with our opinion in Krase v. Life Ins. Co. of North America, No. 11 C 7659, 2012 WL 4483506 (N.D.Ill. Sept. 27, 2012),
Krase has moved to compel LINA to produce four documents that LINA has withheld on grounds of attorney-client privilege, arguing that the documents fall within the "fiduciary exception" to the privilege. "Under that exception, a fiduciary of an ERISA plan `must make available to the beneficiary, upon request, any communications with an attorney that are intended to assist in the administration of the plan.'" Bland v. Fiatallis N. Amer. Inc., 401 F.3d 779, 787 (7th Cir.2005). The exception does not apply to "[d]ecisions relating to the plan's amendment or termination," which are "not fiduciary decisions." Id. at 788.
LINA argues that the fiduciary exception does not apply because we dismissed Krase's § 1132(a)(3) claim for breach of fiduciary duty. (See LINA's Resp. at 6.) In Bland, the Court questioned whether the fiduciary exception was available because the plaintiffs had voluntarily dismissed their claims for breach of fiduciary duty with prejudice. See Bland, 401 F.3d at 787 ("Initially, it is questionable whether the fiduciary exception is even applicable, since the plaintiffs voluntarily dismissed their breach of fiduciary duty claim with prejudice, and thus should perhaps not get the benefit of the exception."). The Court's brief aside is pure dicta: it went on to hold that the exception did not apply because the attorney's advice related to a plan amendment and not to plan administration. Id. at 787-88. LINA has not cited, nor are we aware of, any case holding that the fiduciary exception is unavailable in a case for wrongful denial of benefits against an ERISA fiduciary. Moreover, unlike the plaintiffs in Bland, Krase did not voluntarily abandon his § 1132(a)(3) claim. We dismissed that claim because we concluded that relief was available under 29 U.S.C. § 1132(a)(1)(B). See Krase, 2012 WL 4483506, *2; see also Mondry v. American Family Mut. Ins. Co., 557 F.3d 781, 805 (7th Cir.2009) ("[A] majority of the circuits are of the view that if relief is available to a plan participant under subsection (a)(1)(B), then that relief is un available under subsection (a)(3)."). At the same time, we said that Krase could pursue the same theory underlying his § 1132(a)(3) claim — namely, that LINA wrongfully failed to notify Hansen-Krase of certain policy provisions/benefits — under
A party with discretion to grant or deny benefits is a fiduciary under ERISA. See Wachtel v. Health Net, Inc., 482 F.3d 225, 229-30 (3d Cir.2007) (holding that an insurance company was an ERISA fiduciary because it had "discretion to determine claims covered by its policies") (citing Aetna Health Inc. v. Davila, 542 U.S. 200, 220, 124 S.Ct. 2488, 159 L.Ed.2d 312 (2004)); see also Stephan v. Unum Life Ins. Co. of Amer., 697 F.3d 917, 932 (9th Cir.2012) (similar). LINA baldly states that it lacks such discretion, (see LINA Resp. at 6), but it does not cite any evidence or authority supporting its assertion. The insurance policy states that the "Plan Administrator" (presumably Oce) "has appointed [LINA] as the named fiduciary for deciding claims for benefits under the Plan, and for deciding any appeals of denied claims." (Policy Number FLX 0961910, attached as Ex. A to Compl., at 40.) LINA admits that it denied Krase's appeal of Oce's decision denying Krase's claim for benefits. (See Am. Answer ¶ 20.) Indeed, LINA's in-house counsel concluded that Oce had overstepped its authority by deciding Krase's claim in the first instance. (See Email from M. Grimes to B. Miller et al., dated Aug. 3, 2011, ¶ 3.) We conclude that LINA is an ERISA fiduciary.
We have reviewed in camera the documents that LINA has withheld and conclude that they relate to plan administration. See Bland, 401 F.3d at 787. LINA argues that "the majority of the advice concerns LINA's relationship with Oce as opposed to Plaintiffs' claim for benefits." (LINA's Resp. at 7.) We disagree. Nearly all of the advice provided by LINA's in-house counsel relates specifically to Krase's "Appeal Letter." (See Email from M. Grimes to B. Miller et al., dated Aug. 3, 2011, ¶¶ 1, 4-9.) The letter does discuss Oce, but those statements are also couched in terms of Krase's claim: LINA's attorney disputed Oce's interpretation of the plan and its authority to "self-adjudicate" Krase's claim. (See id. at ¶¶ 2-3.) These are questions of plan administration — is Krase entitled to coverage, and who decides? — not plan "adoption, modification, or termination." Wachtel, 482 F.3d at 233; see also Bland, 401 F.3d at 788.
There is a split of authority about whether the fiduciary exception applies
Krase relies on the Ninth Circuit's decision in Stephan v. Unum Life Ins. Co. of Amer., 697 F.3d 917 (9th Cir.2012), which rejected Wachtel and observed that district courts had uniformly done the same. Id. at 931 n. 6 ("Every district court that has considered the question since ... has rejected Wachtel's approach and held that the fiduciary exemption does apply to insurance companies."); see also Smith v. Jefferson Pilot Financial Ins. Co., 245 F.R.D. 45, 49-53 (D.Mass.2007) (analyzing and disputing each step of the Wachtel court's analysis). The Stephan court focused primarily on the ERISA fiduciary's duty "to disclose all information regarding plan administration." Id. at 931; see 29 C.F.R. § 2560.503-1(h)(2)(iii) (to ensure a "full and fair review," the beneficiary is entitled to "all documents, records, and other information relevant to the claimant's claim for benefits"). "Neither the statute nor the regulations provide any reason why the disclosure of information is any less important where an insurer, rather than a trustee or other ERISA fiduciary, is the decisionmaker." Id. at 932; see also Klein v. Northwestern Mut. Life Ins. Co., 806 F.Supp.2d 1120, 1130 (S.D.Cal. 2011) ("[T]here is no reason to assume that Congress intended to exempt insurance companies from the disclosure obligations of ERISA simply because it exempted them from the requirement to hold plan assets in trust."). Likewise, the court concluded that "the obligation that an ERISA fiduciary act in the interest of the plan beneficiary does not differ depending on whether that fiduciary is a trustee or an insurer." Id.
We agree with the reasoning in Stephan, Smith, and Klein and conclude that the fiduciary exception applies to insurers in ERISA cases. The Wachtel court relied heavily on the fact that insurers pay benefits from their own assets, and
Smith, 245 F.R.D. at 53. As we discussed earlier in this opinion, the fiduciary exception does not eliminate the attorney-client privilege entirely. It applies only to advice regarding plan administration and must give way after the insurer's and the beneficiary's interests have diverged. See Wachtel, 482 F.3d at 233-34. We believe that the exception is sufficiently clear and circumscribed to ameliorate the chilling effect that concerned the Wachtel court.
Krase's motion to compel [53] is granted. LINA is ordered to turn over the documents identified on its privilege log to Krase by July 22, 2013.