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Plan Administrator Was Entitled to Abuse of Discretion Standard of Review Despite Absence of Word 'Discretion' in Plan Documents
Hodgson Russ LLP Link to more items from this source
July 1, 2021

"The Second Circuit panel held that Aetna was granted discretionary authority ... for the following reasons: [1] The plan document need not actually use the word 'discretion,' so long as the benefit plan gives authority to determine eligibility for benefits.... [2] The plan ... [stated] that Aetna would decide claims in accordance with 'reasonable' claims procedures. Because Aetna was permitted to apply its subjective judgment, the court held Aetna was delegated discretionary authority over claims.... [3] Aetna created the procedures to implement its review of eligibility determinations, thereby indicating it held discretionary authority." [Tyll v. Stanley Black & Decker Life Ins. Program, No. 20-1060 (2d Cir. May 4, 2021, unpub.)]  MORE >>

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