Anna Fay and Louis Fay v. Oxford Health Plan, Mount Sinai Medical Center Point-Of-Service-Plan

How courts have described this case

Verbatim parenthetical descriptions written by other courts when citing this decision. Ranked by citation-network relevance.

• holding that fiduciary bears burden of proof on issue of standard of review “since the party claiming deferential review should prove the predicate that justifies it”
• concluding that the benefit plan there considered “invoke[d] discretion by defining ‘Medically Necessary’ as those services which, ‘as determined by [the] ... Medical Director,’ meet four listed requirements” (emphasis in original) (second alteration in original
• noting that Court reads plan as a whole, giving priority to plain meaning of its terms
• noting that de novo standard would apply when parties did not discuss plan language but agreed that de novo standard applied
• defining Qualified Dental Professional as “[a]ny of the following professionals” listed in the bullet points
• defining Rehabilitation Plan with a bullet point list connected by an “and”

Source: CourtListener parenthetical corpus (CC0).