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Discretionary debate: state insurance regulators are increasingly invalidating discretionary clauses, finding such provisions violate specific state insurance laws.(Regulatory/Law: Legal Insight)

Publication: Best's Review
Publication Date: 01-JUN-07
Format: Online
Delivery: Immediate Online Access

Article Excerpt
Most group disability policies are governed by the federal Employee Retirement Income Security Act of 1974. Although ERISA does not prescribe a standard of judicial review for benefits decisions, the U.S. Supreme Court resolved this issue in Firestone Tire & Rubber Co. v. Bruch.

The court...

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...explained that denials of ERISA benefits should "be reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms...

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