McCauley v. First Unum Life Insurance

How courts have described this case

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

• concluding that administrator’s “reliance on one medical report . . . to the detriment of a more detailed contrary report without further investigation was unreasonable”
• inferring that a conflict had affected the defendant’s decisionmaking because nothing else explained its failure to allow the plaintiff to cure certain defects in his claim
• finding that a plan administrator's \reliance on one medical report in support of its denial to the detriment of a more detailed contrary report without further investigation was unreasonable\
• inferring that a conflict had affected the defendant’s decisionmaking because nothing else explained its failure to allow the plaintiff to cure certain defects in his claim
• explaining that in applying the arbitrary and capricious standard, “[w]here both the plan administrator and a spurned claimant offer rational, though conflicting, interpretations of plan provisions, the administrator’s interpretation must be allowed to control”
• stating that the unreasonable behavior described in the opinion was “exacerbated by First Unum’s conflict of interest, as both administrator and payor, for what else would have influenced First Unum to avoid following up on simple inquiries”

Source: CourtListener parenthetical corpus (CC0).