A.W., FATHER OF S.F., AND G.W., CHILDREN v. DEPARTMENT OF CHILDREN AND FAMILIES

How courts have described this case

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

• reviewing the decision of a committee tasked with appeals rather than the decision of a medical director who initially denied plaintiff’s benefits
• the “language of the Plan controls as does the Committee’s ruling as long as it is reasonable”
• “Under the arbitrary and capricious standard, it is not our function to decide whether we would reach the same conclusion as the Plan or even rely on the same authority.”
• not arbitrary and capricious for plan to deny coverage for treatment related to gastric stapling surgery notwithstanding its agreement to pay for another remedial procedure, where plan noted it would pay for no future surgeries related to gastric stapling
• it is not the court’s function “to decide whether [it] would reach the same conclusion as [an administrator] or even rely on the same authority. Instead, the court is only to determine if the decision was downright unreasonable.”
• examining appropriate level of review under abuse of discretion standard

Source: CourtListener parenthetical corpus (CC0).