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5th Circ. Lowers Bar To Review Benefits Claims Denials

Law360 (March 2, 2018, 8:09 PM EST) -- A majority of the full Fifth Circuit has adopted a lower standard for reviewing decisions by benefits plan administrators to deny coverage to workers, overturning a precedent that conditioned judges’ review power on whether an appeal turns on facts or plan interpretation.

Eight of 14 judges said Thursday that courts should apply de novo review — analyze a denial of benefits anew — unless the plan’s documents explicitly give its administrator sole discretion to consider claims. They overturned the court’s 1991 Pierre v. Connecticut General Life...
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Case Information

Case Title

Ariana M. v. Eyesys Vision Inc. Plan

Case Number



Appellate - 5th Circuit

Nature of Suit

3110 Insurance

Date Filed

March 18, 2016

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