The lesson taught by Okuno v. Reliance Standard Life Ins. Co., 2016 WL 4655741 (6th Cir. September 7, 2016), is that the answer to the question posed by the title of this blog is a resounding NO.
Courts strive to enforce the terms of benefit plans in order to ensure their efficient operation.However, there are times when the provisions of benefit plans make no sense under the circumstances; and Waskiewicz v. Unicare Life and Health Ins. Co., 2015 WL 5751585 (6th Cir. October 2, 2015) illustrates one of those circumstances.
In Criss v. Union Security Ins.Co., 2014 WL 2707774, 2014 U.S.Dist.LEXIS 79300 (N.D.Ala. June 11, 2014), Judge William Acker, Jr. challenged the current methodology utilized by courts in adjudicating benefit disputes brought under ERISA. The court based its premise on the universally recognized legal maxim, nemo judex in causa sua; i.e., "No man should be the judge in his own case." (citing Chief Justice Sir Edward Coke in Dr. Bonham's Case, 8 Co. Rep. 107a, 77 Eng. Rep. 638 (C.P. 1610)). In derogation of that principle, the court noted that "clearly conflicted ERISA plan administrators and insurers, when granted by the plan document that they drafted full discretion to interpret their plans and to decide the ultimate issue of entitlement, are routinely allowed, even required, to rule on their own cases."