Carl L. Farley v. Benefit Trust Life Insurance Company, Carl L. Farley v. Benefit Trust Life Insurance Company

How courts have described this case

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

• holding that waiver requires a “voluntary and intentional relinquishment of a known right”
• agreeing that it was the beneficiary’s burden to show that he was entitled to the benefits under the terms of his plan
• noting an ERISA claimant had the “burden to show that he was entitled to the ‘benefits . . . under the terms of his plan.’” (quoting § 1132(a)(1)(B))
• burden of proof is on ERISA plaintiff to establish medically necessity where it is prerequisite for entitlement to benefit
• “[n]or do we consider the language of any of the criteria so vague as to be ambiguous or unenforceable”
• plaintiff had burden of proving coverage for “medically necessary care” where such language was tied to the benefits section of the policy, rather than to exclusions

Source: CourtListener parenthetical corpus (CC0).