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Court Says No Specific Wording Required in Plan Document to Provide Discretionary Claims Authority
The Wagner Law GroupLink to more items from this source
June 18, 2021

"On appeal, the Second Circuit determined that the plan's provisions 'establish a subjective standard by which [the insurer] can make claims eligibility decisions', and, therefore, the plan delegates discretionary authority to the insurer over benefit claims and denials. It ruled that the word 'reasonable' indicates a discretionary standard because there is a broad range of permissible choices within which the insurer may resolve claims." [Tyll v. Stanley Black & Decker Life Ins. Program, No. 20-1060 (2d Cir. May 4, 2021, unpub.)]

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