Hca Health Services of Georgia, Inc. v. Employers Health 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 plaintiffs in ERISA cases must exhaust their administrative remedies before bringing suit in federal court
• noting that, “[t]he reason the claimant’s reasonable interpretation does not [automatically] trump the claims administrator’s wrong interpretation is because the plan documents explicitly grant the claims administrator discretion to interpret the plan”
• applying de novo review, initially, to decide whether the claim was wrongly decided, and if an inherent conflict of interest exists, requiring the administrator to prove that its interpretation was not tainted by self-interest
• “At each step, the court makes a determination that results in either the progression to the next step or the end of the inquiry.”
• “At each step, the court must make a determination that results in either the progression to the next step or the end of the inquiry”
• “At each step of this analysis, the court makes a determination that results in either the progression to the next step or the end of the inquiry.”

Source: CourtListener parenthetical corpus (CC0).