stating that “[a] full trial de novo in any ERISA dispute where 13 there was a genuine dispute of fact as to whether the individual qualified for a benefit would 14 undermine” the policies underlying ERISA; “[t]he means that suggests itself for accomplishing 15 trial of disputed facts, while preserving the value of the fiduciary review procedure, keeping costs 16 and premiums down, and minimizing diversion of benefit money to litigation expense, is trial on 17 the administrative record, in cases where the trial court does not find it necessary under Mongeluzo 18 to consider additional evidence”
How later courts described this case
- stating that “[a] full trial de novo in any ERISA dispute where 13 there was a genuine dispute of fact as to whether the individual qualified for a benefit would 14 undermine” the policies underlying ERISA; “[t]he means that suggests itself for accomplishing 15 trial of disputed facts, while preserving the value of the fiduciary review procedure, keeping costs 16 and premiums down, and minimizing diversion of benefit money to litigation expense, is trial on 17 the administrative record, in cases where the trial court does not find it necessary under Mongeluzo 18 to consider additional evidence”
- explaining that in a trial on the administrative record, “[the] district judge will be 20 asking . . . as he reads the evidence, . . . whether [the plaintiff] is disabled within the terms of the 21 policy” and may “evaluate the persuasiveness of conflicting testimony and decide which is more 22 likely true”
- explaining that in a trial on the administrative record, “[the] district judge will be asking . . 19 . as he reads the evidence, . . . whether [the plaintiff] is disabled within the terms of the policy” 20 and may “evaluate the persuasiveness of conflicting testimony and decide which is more likely 21 true”
- explaining that in a trial on the administrative record, “[the] district judge will be asking . . 4 . as he reads the evidence, . . . whether [the plaintiff] is disabled within the terms of the policy” 5 and may “evaluate the persuasiveness of conflicting testimony and decide which is more likely 6 true”
Written by the judges who cited it.
The opinion
FLETCHER, Circuit Judge,
concurring in part and dissenting in part from Judge Kleinfeld’s plurality opinion, and concurring in full in Judge Silverman’s opinion:
Although I concur in Judge Silverman’s opinion, in light of the fragmented views of the court, I must say more. Apparently the case will be remanded to the district court. A majority of the court agrees that the district court got it wrong in one respect or another and must reconsider.
The majority agrees that the district court’s review must be de novo. The district court labeled its review de novo, and purported to review only for summary judgment. However it then proceeded to weigh the evidence and reach a decision on the merits, rather than to determine only whether material issues of disputed fact existed. Now the majority returns the case to the district court to do it again.
Let us disabuse the district court that its role is to grant or deny summary judgment. A district court, in a case that requires de novo review of the denial of ERISA benefits, is performing a different function. First, it must determine whether the record made before the administrator is adequate. Either on the record that was before the administrator or after admitting additional evidence, the district court then reviews the claim on the merits. It should review a record that is sufficiently developed “to enable the full exercise of informed and independent judgment.” Mongeluzo v. Baxter Travenol Disability Ben. Plan, 46 F.3d 938 , 943 (9th Cir.1995). Summary judgment, in contrast, is a vehicle for the timely disposition of cases as a matter of law. The exercise is to determine whether there are disputes of material fact that necessitate trial. See FED. R. CIV. P. 56 advisory committee’s note. In the ERISA context, where the review is de novo, the issue is not whether judgment as a matter of law is appropriate, but whether additional evidence is required to enable the district court to render an informed decision on an adequate record. Such evidence should be received by whatever means is appropriate (live testimony or affidavits, for example). Once the record is sufficiently developed, the district court should render its decision to grant or deny benefits. The district court makes whatever factual findings are necessary and rules on the claim for benefits.
Since the majority insists the case is going back, the district court must start fresh. It must follow the dictates of Mon-geluzo and must see that the record is developed fully “to enable the full exercise of [its] informed and independent judgment.” Mongeluzo, 46 F.3d at 943.