ERISA Standard of Review

Back to Insights

Case guidelines not meant as rigid formula that dictates outcome

A recent ruling from the 1st U.S. Circuit Court of Appeals upheld an insurance company’s denial of health-care benefits for psychiatric treatment. Although the underlying facts are compelling, the most interesting aspect of the ruling was the court’s discussion of civil procedure and judicial standards of review under the Employee Retirement Income Security Act. The […]

When can a Social Security determination be admitted into evidence in an ERISA long-term disability benefit case?

Because federal courts generally consider the scope of their review of an ERISA benefit denial as being limited to review of a record, what happens if significant material evidence such as a Social Security determination becomes available only after the claim appeals are exhausted. If the standard of judicial review is arbitrary and capricious, it […]

Finding conflicts of interest

A recent case involving the FedEx disability program, Mason v. Federal Express Corp., 2016 WL 706163 (D. Alaska February 22, 2016), illustrated how exposure of conflicts of interest in a claim determination affects a court’s review of the evidence. The case involved Maurice Mason, a FedEx employee who suffered from an auto-immune disorder known as […]

Discretionary clauses and choice of law in ERISA cases

The standard of judicial review utilized in cases brought under the Employee Retirement Income Security Act (ERISA) is critical and may even be outcome-determinative. The parties often vehemently assert their positions in litigation, with the plaintiffs strenuously claiming the right to a de novo standard of judicial review, while the defendants argue just as forcefully […]