Khoury v. Group Health Plan, Inc.

How courts have described this case

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

• holding that “district court was required to give conflict some weight, but the existence of the conflict alone [was] not determinative” when record contained no evidence of claims administration history or of claims administrator’s “efforts to reduce potential bias and to promote accuracy”
• explaining that “the existence of a conflict should be weighed more heavily ‘where circumstances suggest a higher likelihood that it affected the benefits decision’” (quoting Glenn, 554 U.S. at 117)
• explaining that when a claimant is “unable to state how the existence of a conflict of interest impacted the claims decision,” a court must give the conflict “some weight,” but it should not be “determinative”
• “We decline to decide the propriety of the use of summary judgment procedures in this case because the issue was not raised by the parties.”
• first citing Galman v. Prudential Ins. Co. of Am., 254 F.3d 768, 770–71 (8th Cir. 2001); and then citing Wert v. Liberty Life Assurance Co. of Bos., 447 F.3d 1060, 1066 (8th Cir. 2006)
• “Courts reviewing a plan administrator’s decision to deny benefits will review only the final claims decision, and not the initial, often succinct denial letters, in order to ensure the development of a complete record.” (cleaned up)

Source: CourtListener parenthetical corpus (CC0).