Neurological Resources, P.C. v. Anthem Insurance

HAMILTON, District Judge.

This action presents important and recurring questions about the standards that courts apply when reviewing decisions to deny benefits under employee benefit plans governed by the federal Employees Retirement Income Security Act (ERISA). The issues are whether standard terms in group health insurance plans that do not explicitly grant discretionary power to a plan administrator to construe ambiguous terms or to determine eligibility for benefits nevertheless satisfy the standards established in Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 109 S.Ct. 948, 103…