Elena v. Reliance Standard Life Ins. Co.
| Decision Date | 20 April 2022 |
| Docket Number | 21-cv-00390-GPC |
| Parties | JIZHELL ELENA, an individual, Plaintiff, v. RELIANCE STANDARD LIFE INSURANCE COMPANY, an Illinois corporation doing business in the state of California; MATRIX ABSENCE MANAGEMENT, INC., a Delaware corporation doing business in the state of California; and DOES 1-50, inclusive, Defendants. |
| Court | U.S. District Court — Southern District of California |
ORDER DENYING IN PART AND GRANTING IN PART DEFENDANTS' MOTION FOR SUMMARY JUDGMENT
Defendants Reliance Standard Life Insurance Company (“Reliance”) and Matrix Absence Management (“Matrix”) (collectively “Defendants”) filed a Motion for Summary Judgment on Plaintiff Jizhell Elena's (“Elena” or “Plaintiff”) claim for intentional infliction of emotional distress, seeking dismissal of Plaintiff's entire First Amended Complaint. ECF No. 22. Upon consideration of the moving papers and the case record, the Court HEREBY DENIES IN PART AND GRANTS IN PART Defendants' Motion for Summary Judgment.
This case arose against the backdrop of a long-term disability insurance claim. Plaintiff was employed with Limited Brands (or “L Brands”), the parent company of Victoria's Secret, for about ten years, beginning in 2008. Elena Depo. 47:10-47:19 (ECF No. 31-1 at 20). Around June 2018, she began experiencing severe symptoms including an inability to stand, swelling in her lower extremities, swelling in her hands, and uncontrollable bloody bowel movements. Id. 48:22; 51:1-51:4. She began treatment with Dr. Anselmo Roldan in June 2018 and was diagnosed with systemic lupus, arthropathy (joint disease), and chronic pain. Id. 48:22-48:23; ECF No. 31-1 at 43 (). Plaintiff's severe illness and attendant diagnosis meant that she was no longer able to work. ECF No. 31-1 at 50. Plaintiff was entitled to long term disability coverage through a group policy that Reliance issued to Plaintiff's employer, L Brands. ECF No. 31-2 at 2 (Plaintiff's Response to Defendants' Undisputed Material Facts No. 1 (“Plaintiff's UF”)). Plaintiff submitted a claim to Reliance, which was handled by Matrix, and which was received on June 19, 2018. Elena Depo. 50:19-50:21; Plaintiff's UF at 2. Senior Claims Examiner Allen Wittig (“Wittig”) was assigned to Plaintiff's claim and began working on it on June 20, 2018. Plaintiff's UF at 2.
What follows is a timeline of criss-crossing exchanges in which Plaintiff and her providers state that they timely provided all requested documents, and Defendants claim that Plaintiff and her providers repeatedly failed to provide these documents. At the beginning of the claims process, Matrix requested that Plaintiff's doctor complete paperwork describing her diagnosis and inability to work, which Dr. Roldan completed and which was faxed to Matrix on June 28, 2018. ECF No. 31-1 at 43-45 (Ex. 2 to Plaintiff's NOL). On June 31, 2018, Plaintiff also completed a medical release authorizing Matrix to contact her healthcare providers directly to obtain her records. Id. at 48 (Ex. 3 to Plaintiff's NOL).
Wittig first attempted to contact Plaintiff by phone on July 9, 2018 and July 11, 2018. ECF No. 23 at 2 (Lorenzo Decl. ¶ 6). On July 12, 2018, Plaintiff and Wittig spoke on the phone for the first time. Id. ¶ 7. On July 19, 2018, Plaintiff completed and faxed a second copy of the medical release she had completed on June 31, 2018. ECF No. 31-1 at 48 (Ex. 3 to Plaintiff's NOL). On the same day, July 19, 2018, Dr. Roldan sent Matrix a Medical Disability Certification Application for Disability Benefits describing Plaintiff as unable to walk or to use her hands and fingers. Id. at 52 (Ex. 4 to Plaintiff's NOL). The document's footer is stamped with “Matrix RCVD via FAX 07/19/2018.” Id. On August 7, 2018, Dr. Roldan completed another Health Care Provider Certification, this time with specific Diagnosis codes, indicating again that Plaintiff was unable to work due to joint pain, edema, swelling, and major depression. Id. at 54 (Ex. 5 to Plaintiff's NOL).
On June 20, 2018 and July 24, 2018, Matrix issued letters to Plaintiff stating that information had been requested from Plaintiff and Dr. Roldan, and requesting Plaintiff's attention to the matter. ECF No. 26 at 20-23. On July 24, 2018 and August 22, 2018, Matrix contacted Dr. Roldan and requested fax copies of Plaintiff's medical records. Id. at 32-34. On August 22, 2018, Matrix issued a letter stating that it had not received medical records from either Plaintiff or Dr. Roldan documenting her disability. ECF No. 27 at 24. The letter warned that if the information was not received by September 17, 2018, Plaintiff's claim would be closed. Id. at 25.
On August 26, 2018, Plaintiff emailed Wittig to express confusion and frustration over the repeated assertions that Matrix had not received her medical records. ECF No. 31-1 at 58 (Ex. 6 to Plaintiff's NOL). In the email, Plaintiff stated: Id. Wittig did not reply, nor was the email logged in Plaintiff's claim file. See ECF No. 26 at 10-11 (). On September 18, 2018, Matrix sent a letter to Plaintiff informing her that her disability benefits claim had been denied for failure to provide medical records. ECF No. 31-1 at 60 (Ex. 7 to Plaintiff's NOL).
As 2019 began, Plaintiff's savings became depleted, and though she initially tried to stay with friends, she eventually became homeless. Id. at 10 (Ex. 1 to Plaintiff's NOL). She slept on the beach in Seaport Village, San Diego during the spring of 2019. Id. at 13. At that time, she had a government-issued phone that was provided to the homeless, which she could use to make calls for a fee. Id. at 15. Plaintiff does not recall the phone number assigned to this cellphone, but states that she used this phone to call Wittig in March and that the number did not begin with a 619 or 858 area code. Id. at 16. She also used pay phones, including one at the Bayer Boulevard trolley station and a pay phone outside a shelter by “12th and Imperial.” Id. at 16; 27. Plaintiff does not believe that her personal cellphone, with a phone number ending in 0221, was working at the time. Id. Instead, she states that she relied primarily on pay phones. During this time, Plaintiff and Wittig continued to communicate regarding Plaintiff's claim.
The calls between Plaintiff and Wittig/Matrix regarding Plaintiff's disability file form the crux of Plaintiff's intentional infliction of emotional distress claim. Defendants assert that Plaintiff and Wittig spoke only three times: on July 12, 2018, October 2, 2018, and then not again until March 19, 2019. ECF No. 22-3 at 5 (Ex. A to Petermann Decl.). Plaintiff claims that she and Wittig spoke by phone around 25-30 times. ECF No. 28-1 at 12 (Elena Depo.). Plaintiff states that Wittig's comments were “dismissive from the beginning” but that in early 2019, the comments became more distressing and abusive. ECF No. 31-1 at 17 (Ex. 1 to Plaintiff's NOL). According to Plaintiff, Wittig commented that he couldn't hear her because the trolley was too loud, which Plaintiff then explained was because she had to use a pay phone. Id. at 17. Plaintiff also states that Wittig said, Id. at 18. Plaintiff also called the Suicide Hotline (or “the Suicide Help Line”) as a result of a conversation with Wittig in February 2019. Id. at 11. After Plaintiff mentioned to Wittig in March of 2019 that she had called the Suicide Help Line, he reportedly asked how she would “go about that [committing suicide] if she were disabled.” Id. at 12.
Plaintiff then told him she was going to “walk off Coronado Bridge, and put his name on my body somewhere with his phone number so people would know what he was doing.” Id. During that same conversation, Witting reportedly got irritated and said he could not understand Plaintiff because “her Mexican [accent] was too thick.” Id. at 12-13. Plaintiff then tried to ask for a supervisor but was told that Wittig was a senior advisor, “so that's as high as it goes.” Id. at 14. She then tried calling the HR department at Limited Brands, her former employer, to try and resolve the situation, but never received a call back from anyone at Matrix. Id. After that, Plaintiff began looking for a lawyer. Id. at 15.
Defendants state that around March 20, 2019, they finally received Plaintiff's medical paperwork, and that Wittig forwarded the records for internal medical review and evaluation. ECF No. 23 at 4 (Lorenzo Decl.). On April 3, 2019 Plaintiff's claim was internally approved at Matrix. ECF No. 27 at 14. On April 4, 2019, Plaintiff's newly retained counsel, Attorney Matt Blum, contacted Wittig by email for the first time, notifying Wittig that Plaintiff was now represented and that all future correspondence should be sent directly to Blum. ECF No. 26 at 15. Wittig responded on April 5, 2019, asking for a letter of representation. Id. On April 10, 2019, Matrix approved Plaintiff's disability claim and notified her via letter. ECF No. 26 at 30-31. On the same day, Wittig emailed Plaintiff's attorney, Blum, notifying him of the approval. Id. at 19. Plaintiff contends that Blum's appearance on the scene was what prompted the approval, and that...
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