United States District Court, D. Maine
ORDER ON BENEFITS OWED TO THE PLAINTIFF AND
BROCK HORNBY United States District Judge.
April 28, 2016, I granted the plaintiff Adele E.’s
motion for judgment on the administrative record and ordered
the parties to submit briefing regarding the calculation of
benefits owed to the plaintiff, whether to award prejudgment
interest, and, if awarded, the rate to be applied. Both
parties have submitted two briefs on these issues. After
considering the parties’ positions, I conclude that the
plaintiff is entitled to judgment in the amount of $188,
500.00, with prejudgment interest in the amount of $16,
163.54, and postjudgment interest as provided by statute,
accruing from the entry of judgment, June 30, 2016.
See 28 U.S.C.A. § 1961(a) (2006 & Supp.
2015); Radford Trust v. First Unum Life Ins. Co. of
Am., 491 F.3d 21, 24 (1st Cir. 2007).
Calculation of Benefits Owed
plaintiff paid RainRock for 130 days of residential treatment
that, I have concluded, Anthem should have provided. She paid
$1, 450 per day. As a result, she is entitled to judgment in
the amount of $188, 500.00. See Pl.’s Resp. to
June 1, 2016 Proc. Order & Attached Exs. (ECF No. 48).
Anthem argues that I should calculate benefits using a
discounted rate that RainRock provides to Anthem. But
RainRock is not a party here, and therefore I have no
occasion to determine what the contract between Anthem and
RainRock requires; any disagreement regarding an applicable
discount is between Anthem and RainRock. The plaintiff is
entitled to recover what Anthem’s wrongful denial of
benefits cost her to continue her medically necessary
treatment at RainRock, namely, $188, 500.00.
ERISA cases, the district court has broad discretion both to
determine whether to award prejudgment interest and to
determine the parameters of such an award.” Radford
Trust, 491 F.3d at 23-24. “The essential rationale
for awarding prejudgment interest is to ensure that an
injured party is fully compensated for its loss.”
City of Milwaukee v. Cement Div., Nat’l Gypsum
Co., 515 U.S. 189, 195 (1995). Based on Anthem’s
erroneous denial of benefits owed to the plaintiff,
see Decision & Order on Cross-Mots. for J. on
the Admin. R. at 18-19 (ECF No. 40), and the
plaintiff’s significant out-of-pocket expenses for
continuing her medically necessary treatment at RainRock,
see Pl.’s Resp. to June 1, 2016 Proc. Order at
2, I conclude that prejudgment interest shall be awarded to
rule in this District is that prejudgment interest accrues
from the denial of the plaintiff’s administrative
appeal. Giroux v. Fortis Benefits Ins. Co., 353
F.Supp.2d 45, 54 (D. Me. 2005). After two internal appeal
levels, Anthem finally upheld the denial of benefits
rightfully owed to the plaintiff on November 26, 2013.
See R. at 1025-1027. Prejudgment interest shall
therefore run from November 26, 2013, until the date of entry
of judgment in this case, June 30, 2016. See also Black
v. Unum Life Ins. Co. of Am., 324 F.Supp.2d 206, 219 (D.
Me. 2004); Curtin v. Unum Life Ins. Co. of Am., 298
F.Supp.2d 149, 158-59 (D. Me. 2004).
Rate of Prejudgment Interest
court “has broad discretion to choose the rate of
prejudgment interest.” Black, 324 F.Supp.2d at
219 (citing Cottrill v. Sparrow, Johnson & Ursillo,
Inc., 100 F.3d 220, 225 (1st Cir. 1996), abrogated
on other grounds by Hardt v. Reliance Standard Life Ins.
Co., 560 U.S. 242 (2010)). Following the precedents from
this District, see Giroux, 353 F.Supp.2d at 54;
Black, 324 F.Supp.2d at 219; Curtin, 298
F.Supp.2d at 159, which have been deemed reasonable by the
First Circuit, see Marcial Ucin, S.A. v. SS Galicia,
558 F.Supp. 299, 303 (D. Mass.), aff’d, 723
F.2d 994 (1st Cir. 1983); see also Pimentel v. Jacobsen
Fishing Co., Inc., 102 F.3d 638, 640 (1st Cir. 1996);
City of Boston v. S.S. Texaco Tex., 773 F.2d 1396,
1401 (1st Cir. 1985), and guided by equitable considerations,
I calculate the plaintiff’s prejudgment interest award
using the relevant federal bank prime loan rates for each day
of the period in question. Therefore, the per diem rate of
prejudgment interest between November 26, 2013, and December
16, 2015, which is 751 days, is $16.78, and the per diem rate
between December 17, 2015, and June 30, 2016, which is 197
days, is $18.08, for a total of $16, 163.54 in prejudgment
shall be entered in favor of the plaintiff Adele E. in the
amount of One Hundred Eighty-eight Thousand Five Hundred
Dollars ($188, 500.00), along with prejudgment interest at
the federal bank prime loan rate from November 26, 2013,
until June 30, 2016, in the amount of Sixteen Thousand One
Hundred Sixty-three Dollars and Fifty-four Cents ($16,
163.54). Postjudgment interest will be awarded as provided by
statute, accruing from the entry of judgment, June 30, 2016.