Black v. Long Term Disability Insurance
(7th Cir. [ Wis.] September 18, 2009)
After being denied coverage under her employer’s long term disability plan, an employee filed an ERISA action for benefits. The employee argued that the court should review the matter under a de novo standard. The Seventh Circuit held that the benefits determination was subject to an arbitrary and capricious standard of review rather than de novo because the plan grants the insurer discretion in its benefits determinations. Since the insurer based its determination upon the findings of five consulting physicians who concluded the employee’s condition was not disabling, the court held that the decision was rationally supported by the record.
For a copy of the decision, click here
By Bryan D. Richmond and Kimberly E. Whistler