Ramsteck v. Aetna Life Ins. Co.
S.D.N.Y., June 24, 2009
Concluding the plaintiff had a full and fair review of her medical claim, the district court held the plan administrator’s decision to deny benefits was reasonable and, therefore, not arbitrary and capricious. Documentation in the administrative record was sufficient to demonstrate the procedure was “experimental and investigational” and not covered under her medical plan. Additionally, the court determined that plaintiff did not demonstrate “good cause” to support a review of testimony outside the administrative record.
For a copy of the decision, click here
By Kimberly E. Whistler