ERISA Ruling Shows Daunting Review Standard For Claimants

Law360 (September 9, 2020, 12:40 PM EDT) -- The most critical issue in Employee Retirement Income Security Act benefits litigation is the standard of judicial review applied by the courts. Under the deferential arbitrary and capricious standard of review, the court reviews a claim record compiled by the insurance company[1] to determine whether a claim denial was "downright unreasonable"[2] and not merely wrong.

Because the court will uphold a benefit denial so long as there is reasonable support for the conclusion reached, it is no exaggeration to view the arbitrary and capricious standard to mean, as the U.S. Court of Appeals for the Seventh Circuit observed in 2000, that the...

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