Hovan v. Metropolitan LIfe Insurance Co.

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Hovan was employed as a commercial litigator with
Troutman Sanders LLP. She worked in complex litigation,
including class actions, intellectual property disputes, and
commercial arbitrations. Hovan’s job required her to make
reasoned decisions, use critical thinking skills, solve complex
problems, manage an involved workload, multitask efficiently, and
interact appropriately with clients, coworkers, and judges. Hovan’s
ability to perform these functions came into question when she
sought disability benefits in relation to her bipolar disorder
diagnosis.
Troutman Sanders provided its employees with long-term
disability coverage (the “Plan”) through a group policy issued by
MetLife. MetLife served as the claims administrator.
Under the Plan, MetLife was required to pay benefits to any
covered employee who became and remained disabled. The Plan
gave MetLife “discretionary authority to interpret the terms of the
Plan and to determine eligibility for and entitlement to Plan
benefits,” and further provided that any such interpretation or
determination “shall be given full force and effect, unless it can be
shown that the interpretation or determination was arbitrary and
capricious.”
For claimants disabled by a mental or nervous disorder, the
Plan authorized up to 24 months of benefits if the claimant was
unable to “perform each of the material duties of [her] Own
Occupation.” The Plan defined “Own Occupation” as:
[T]he duties that You regularly perform and that
provides Your primary source of earned income. For
Attorneys, Own Occupation means the specialty in
the practice of law in which You were engaged just
prior to the date Disability started. Such job is not
limited to the specific position You have with the
Policyholder or could have with any other employer.

The Plan further specified that “Your Disability benefit payments
will end . . . the date You fail to provide required Proof of
continuing Disability.”
Hovan was first diagnosed with bipolar disorder in 2005,
when she experienced two manic episodes requiring
hospitalization and treatment with medication. After stabilizing,
she discontinued medication in 2007 and later attended law school.
Her symptoms did not reappear for several years.
In February 2019, Hovan ceased work due to a mental health
crisis stemming from her bipolar disorder. She began treatment
USCA11 Case: 24-111674 Opinion of the Court 24-11167
with psychiatrist Dr. Michael Lara, who reported to MetLife that
Hovan exhibited “impaired judgment,” “poor decision making,”
mood swings, racing thoughts, and that she was “able to engage in
only limited stress situations and . . . limited interpersonal
relations.” In June 2019, Hovan entered an intensive outpatient
program, which she completed the following month.
In late July 2019, MetLife concluded that Hovan was disabled
and approved her claim for long-term disability benefits
commencing on June 1, 2019.
From September 22, 2020, to October 16, 2020, Hovan was
admitted to a partial hospitalization program at PeakView
Behavioral Health in Colorado. Upon her discharge, her PeakView
psychiatrist, Dr. Sohail Punjwani, concluded she had a “good
prognosis.” He wrote:
The patient tolerated all medication
changes/increases well with no complaints of side
effects. This patient is not at imminent risk nor
gravely disabled and safe to discharge. The patient
presents today for routine follow up and medication
management. The patient has no complaints at this
time and reports mood is stable. Patient denies
anxiety or depression. Patient denies difficulty falling
or staying asleep. Patient denies changes in appetite.
Patient denies suicidal or homicidal ideations. Patient
denies visual or auditory hallucinations.
After her discharge from PeakView, Hovan began seeing a
therapist, Ms. Sherrie Stevens. During multiple sessions with Ms.
USCA11 Case: 24-1116724-11167 Opinion of the Court 5
Stevens between November 2020 and early March 2021, Ms.
Stevens documented fluctuations in Hovan’s mood, with
occasional reports of depression, mania, and anxiety. Hovan at
times mentioned fleeting, passive suicidal thoughts but denied any
plan or intent to harm herself. She also admitted to discontinuing
medication because she felt it was unnecessary. Despite these
reports, Ms. Stevens consistently recorded that Hovan’s “functional
status” was “intact,” her affect was “appropriate,” her cognition
was “oriented/alert,” and her interpersonal functioning was
“interactive.” Ms. Stevens did not opine on Hovan’s occupational
limitations or her ability to perform her work as a commercial
litigator.
In January 2021, MetLife reviewed Hovan’s disability claim
and attempted to contact therapist Ms. Stevens. After several
unsuccessful attempts to get in touch with Ms. Stevens, and after
reviewing the available notes that Ms. Stevens wrote during the
therapy sessions, MetLife notified Hovan of its decision to
terminate her disability benefits. This decision was effective as of
October 16, 2020, the date of her discharge from PeakView.

Outcome: Defendant’s motion for summary judgment granted.

Affirmed