Murray v. Golden Rule Ins. Co.
| Decision Date | 19 May 2014 |
| Docket Number | No. 1:12–cv–01012–JMS–DML.,1:12–cv–01012–JMS–DML. |
| Citation | 23 F.Supp.3d 938 |
| Parties | Donnell MURRAY, Plaintiff, v. GOLDEN RULE INS. CO. /UNITED HEALTH CORP., Defendant. |
| Court | U.S. District Court — Southern District of Indiana |
Jason R. Ramsland, Ball Eggleston, Lafayette, IN, for Plaintiff.
Craig W. Wiley, Jackson Lewis LLP, Indianapolis, IN, for Defendant.
Presently pending before the Court is Defendant Golden Rule Ins. Co./ UnitedHealthcare Corp.'s (“Golden Rule”) Motion for Summary Judgment. [Filing No. 34. ]1
A motion for summary judgment asks the Court to find that a trial is unnecessary because there is no genuine dispute as to any material fact and, instead, the movant is entitled to judgment as a matter of law. See Fed.R.Civ.P. 56(a). As the current version of Rule 56 makes clear, whether a party asserts that a fact is undisputed or genuinely disputed, the party must support the asserted fact by citing to particular parts of the record, including depositions, documents, or affidavits. Fed.R.Civ.P. 56(c)(1)(A). A party can also support a fact by showing that the materials cited do not establish the absence or presence of a genuine dispute or that the adverse party cannot produce admissible evidence to support the fact. Fed.R.Civ.P. 56(c)(1)(B). Affidavits or declarations must be made on personal knowledge, set out facts that would be admissible in evidence, and show that the affiant is competent to testify on matters stated. Fed.R.Civ.P. 56(c)(4). Failure to properly support a fact in opposition to a movant's factual assertion can result in the movant's fact being considered undisputed, and potentially in the grant of summary judgment. Fed.R.Civ.P. 56(e).
On summary judgment, a party must show the Court what evidence it has that would convince a trier of fact to accept its version of the events. Johnson v. Cambridge Indus., 325 F.3d 892, 901 (7th Cir.2003). The moving party is entitled to summary judgment if no reasonable fact-finder could return a verdict for the non-moving party. Nelson v. Miller, 570 F.3d 868, 875 (7th Cir.2009). The Court views the record in the light most favorable to the non-moving party and draws all reasonable inferences in that party's favor. Darst v. Interstate Brands Corp., 512 F.3d 903, 907 (7th Cir.2008). It cannot weigh evidence or make credibility determinations on summary judgment because those tasks are left to the fact-finder. O'Leary v. Accretive Health, Inc., 657 F.3d 625, 630 (7th Cir.2011). The Court need only consider the cited materials, Fed.R.Civ.P. 56(c)(3), and the Seventh Circuit Court of Appeals has “repeatedly assured the district courts that they are not required to scour every inch of the record for evidence that is potentially relevant to the summary judgment motion before them,” Johnson, 325 F.3d at 898. Any doubt as to the existence of a genuine issue for trial is resolved against the moving party. Ponsetti v. GE Pension Plan, 614 F.3d 684, 691 (7th Cir.2010).
The Court finds the following to be the undisputed facts, supported by admissible evidence in the record:
Golden Rule is part of the UnitedHealth Group family of companies, and “specializes in issuing individual and family health insurance policies to individuals who are self-employed, unemployed, or do not receive insurance benefits through their employer.” [Filing No. 35 at 3–4. ] On November 10, 1986, Plaintiff Donnell Murray began working for Golden Rule as a claims trainee. [Filing No. 36–1 at 5–6. ] After a six-week training period, Ms. Murray became a claims adjuster. [Filing No. 36–1 at 6. ] As a claims adjuster, she reviewed claims in order to determine whether they were covered under the terms of the policy at issue. [Filing No. 36–1 at 6. ] This required Ms. Murray to know anatomy, medical terminology, and medical coding. [Filing No. 36–1 at 6. ] She became a Senior Claims Auditor in 2001. [Filing No. 36–1 at 9. ] In this position, Ms. Murray's original supervisor was Janice Koors. [Filing No. 36–1 at 10. ] After a few years, her supervisor became Nancy Novitski. [Filing No. 36–1 at 10. ]
Ms. Murray currently holds this same position at Golden Rule, and Ms. Novitski is still her supervisor. [Filing No. 36–1 at 10. ] Her job duties include auditing case management files and medical case review files, auditing individual claims within her authority, and working on special projects as her supervisor requires. [Filing No. 36–1 at 10. ] She has investigated injury related claims, obtained accident details, and verified insurance, third party and liability coverage. [Filing No. 40–3 at 1. ] While Ms. Murray might flag coverage issues such as whether a certain procedure was medically necessary, she would not actually make that determination but rather would send it back to the appropriate department for analysis. [Filing No. 36–1 at 11. ] She has also investigated and responded to Department of Insurance complaints, and developed knowledge of how to handle grievances and complaints. [Filing No. 40–3 at 1. ]
Ms. Murray holds a four-year degree in elementary education, and obtained her Master's Degree in Business Administration from Indiana Wesleyan University, with a concentration in Human Resources, in December 2011.2 [Filing No. 36–1 at 4. ] Ms. Murray also owns a catering business, [Filing No. 36–1 at 15 ], and held a part-time seasonal testing position with McGraw–Hill from 2001 to 2009, in which she trained thirty-one evaluators in a team leader/trainer/supervisor role, [Filing No. 36–1 at 14 ].
Margaret Gaskey is Director of Investigations for Golden Rule, and manages the Medical History Review, Catastrophic Case Management, and Medical Management units. [Filing No. 36–2 at 2. ] The Catastrophic Case Management unit “performs analyses regarding certain claims to determine whether the treatment [an insured received] is medically necessary and/or experimental/investigational and in turn, whether the claim is covered under the plan of insurance.” [Filing No. 36–2 at 2. ] In late May or early June 2011, Ms. Gaskey posted a job opening in Catastrophic Case Management for the position of Manager of Recovery/Resolution. [Filing No. 36–2 at 3. ] The Manager of Recovery/Resolution “is responsible for the daily workload management for the unit, including review of online work queues and providing direction to staff regarding specific work to be screened[,]” including “reviewing, assigning, and distributing open cases, coaching and directing staff regarding specific cases, and approval of staff decisions on files [,]” and “handling complaints and appeals.” [Filing No. 36–2 at 3. ] The position requires the candidate to have an undergraduate degree or equivalent work experience. [Filing No. 36–2 at 3. ]
Ms. Murray completed an application for the Manager of Recovery/Resolution position, and submitted it online through Golden Rule's intranet site. [Filing No. 36–2 at 3. ] Ms. Gaskey selected Ms. Murray, along with five other candidates, for an interview. [Filing No. 36–2 at 3. ] Three of the candidates selected already worked in the Catastrophic Case Management unit—Crystal Dillon, Malinda Zumer, and Holly Fields. [Filing No. 36–2 at 3. ] Another candidate—Lisa Wheeler—worked in the Medical History Review unit. [Filing No. 36–2 at 3. ] Ms. Murray and the last candidate—her supervisor, Nancy Novitski—worked in the Claims Audit unit. [Filing No. 36–2 at 3. ]
Ms. Gaskey conducted the interviews, and each candidate's interview lasted about an hour. [Filing No. 36–2 at 4. ] Ms. Gaskey believed that Ms. Murray did not perform well during her interview: she “struggled to come up with appropriate responses to [her] questions[;] ... could not articulate why she was the best candidate for the job[;] ... was unable to provide relevant examples of experience at Golden Rule responding to customer service issues [, instead providing] examples from her catering business, employment experiences dating prior to 1986, or experiences in her pursuit of a Master's Degree[; and] failed to provide examples of how she had effectively managed a conflict situation or dispute with a customer in her years of experience at Golden Rule.”3 [Filing No. 36–2 at 4. ] While Ms. Murray has investigated injury related claims, obtained accident details, and verified insurance, third party, and liability coverage while working at Golden Rule, [Filing No. 40–3 at 1 ], Ms. Gaskey concluded that Ms. Murray had no supervisory experience during her tenure there, [Filing No. 36–2 at 4 ]. Ms. Gaskey deemed Ms. Murray “the least qualified” of the candidates she interviewed. [Filing No. 36–2 at 4. ]
Ms. Gaskey ultimately selected Lisa Wheeler, a Medical History Review Lead Specialist, for the Manager of Recovery/Resolution position. [Filing No. 36–2 at 4. ] Ms. Wheeler performed very well during the interview, and had prior experience at Golden Rule in the Catastrophic Case Management and Special Investigations units. [Filing No. 36–2 at 4. ] She also had prior relevant supervisory experience at Golden Rule as a “team lead.” [Filing No. 36–2 at 4. ] Ms. Wheeler does not have an undergraduate degree, but Ms. Gaskey determined that she had the relevant work experience to meet the job requirements. [Filing No. 36–2 at 4. ] Other than Ms. Murray, the remaining unsuccessful candidates are all Caucasian. [Filing No. 36–2 at 5. ]
Sara Amos is the Associate Director of Regulatory Affairs for Golden Rule, in its Indianapolis office. [Filing No. 36–3 at 2. ] Ms. Amos was Ms. Murray's supervisor for a few months in 1990, when Ms. Murray worked as a claims adjuster. [Filing No. 36–3 at 2. ] In June 2011, Ms. Amos posted an opening for the position of Senior Regulatory Affairs Analyst on Golden Rule's intranet site. [Filing No. 36–3 at 2. ] The primary function of the Senior Regulatory ...
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