Gerald W. Killian and Martha R. Killian, as Co-Executors of the Estate of Carolyn Matkin, Deceased v. Healthsource Provident Administrators, Inc.

How courts have described this case

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

• concluding that “there is an actual, readily apparent conflict” where “as administrator, it interprets the plan, deciding what expenses are covered, and as issuer of the policy, it ultimately pays those expenses”
• observing that “there is an actual, readily apparent conflict” where an administrator “interprets the plan, deciding what expenses are covered, and as issuer of the policy, it ultimately pays those expenses”
• characterizing any situation in which the same party both administers and funds a plan as presenting an actual conflict of interest that must be considered as a factor when determining whether the administrator abused its discretion by denying benefits in an arbitrary and capricious manner
• the district court was “strictly limited to a consideration of the information actually considered by the administrator”
• in turn quoting Yeager v. Reliance Standard Life Ins. Co., 88 F.3d 376, 380 (6th Cir. 1996)
• “The key question, however, is what constitutes the universe of information that Healthsource should have considered. . . . Healthsource acted arbitrarily and capriciously in formulating the limitations it placed on the information it would take into account.”

Source: CourtListener parenthetical corpus (CC0).