Heightened Arbitrary And Capricious Standard Of Review

46 Florida cases classified under this topic · sorted by citation count · browse and sort

• Crume v. Metro. Life Ins.
  417 F. Supp. 2d 1258· M.D. Fla.· 2006-02-14 ·cited 14×
  The court held that MetLife's denial of disability benefits was not arbitrary and capricious, as the plaintiff failed to provide sufficient objective medical evidence of a disabling psychiatric impairment precluding her from her own occupation.
• Parness v. Metro. Life Ins.
  291 F. Supp. 2d 1347· S.D. Fla.· 2003-08-13 ·cited 6×
  The court held that the heightened arbitrary and capricious standard of review applies to ERISA benefit denials when the plan grants discretion and the administrator has a conflict of interest, and that review is limited to the administrative record.
• Luton v. Prudential Ins. Co. of Am.
  88 F. Supp. 2d 1364· S.D. Fla.· 2000-03-23 ·cited 6×
  The court held that the term 'mental, psychoneurotic or personality disorder' in the disability plan is ambiguous, and construing it against the insurer, plaintiff's interpretation that his depression is physically based is reasonable, entitling him to benefits.
• Providence v. Hartford Life & Accident Ins.
  357 F. Supp. 2d 1341· M.D. Fla.· 2005-01-12 ·cited 5×
  The court held that the defendant's denial of long-term disability benefits was not wrong, as the plaintiff failed to submit contemporaneous medical evidence establishing she was disabled from performing her essential job duties at the time of her resignation.
• Bazile v. Lucent Techs.
  403 F. Supp. 2d 1174· S.D. Fla.· 2005-11-29 ·cited 4×
  The court held that the plaintiff failed to meet the criteria for disability pension benefits and that his claim of malicious termination was barred by res judicata.
• Epolito v. Prudential Ins. Co. of Am.
  737 F. Supp. 2d 1364· M.D. Fla.· 2010-09-02 ·cited 3×
  The court held that the plan's definition of 'Employer' encompassed Unitrin and its affiliates, meaning pension benefits accrued under a former owner were deductible. The court adopted Florida's contract interpretation rules and the doctrine of contra proferentem for ERISA cases.
• Herman v. Metro. Life Ins.
  689 F. Supp. 2d 1316· M.D. Fla.· 2010-02-11 ·cited 3×
  The court affirmed the magistrate judge's report, granting MetLife summary judgment on the plaintiff's claim for benefits and denying MetLife's counterclaim for reimbursement of overpaid benefits.
• Epolito v. Prudential Ins. Co. of Am.
  523 F. Supp. 2d 1329· M.D. Fla.· 2007-10-10 ·cited 3×
  The court granted Plaintiff's dispositive motion for summary judgment, finding the defendant's denial of benefits was not supported by sufficient evidence and was arbitrary and capricious. The court denied Plaintiff's partial motion regarding offsets, remanding that issue to the
• Fick v. Metro. Life Ins.
  347 F. Supp. 2d 1271· S.D. Fla.· 2004-11-11 ·cited 3×
  The court affirmed the grant of summary judgment for MetLife, finding that MetLife's denial of disability benefits was not 'wrong' under de novo review, thus ending the inquiry.
• Meyer v. Hartford Life & Acc. Ins. Co.
  320 F. Supp. 2d 1256· M.D. Fla.· 2004-04-24 ·cited 3×
  The court held that the plan administrator's denial of long-term disability benefits was not "wrong" under the applicable standard of review, and therefore, summary judgment for the defendant was appropriate.
• Vickers v. Guardian Life Ins. Co. of Am.
  204 F. Supp. 2d 1326· M.D. Fla.· 2002-04-25 ·cited 3×
  The court held that the insurer's denial of benefits was arbitrary and capricious due to a conflict of interest, and granted summary judgment for the beneficiary.
• Schindler v. Metro. Life Ins.
  141 F. Supp. 2d 1073· M.D. Fla.· 2001-04-30 ·cited 3×
  The court held that the plan administrator's decision to terminate disability benefits was correct and reasonable, as the claimant failed to provide sufficient objective medical evidence of total disability, and surveillance contradicted his claims.
• Brown v. BellSouth Telecomms. Inc.
  73 F. Supp. 2d 1308· M.D. Fla.· 1999-08-04 ·cited 3×
  The court held that the arbitrary and capricious standard of review applied to the denial of ERISA benefits because the plan granted discretionary authority to the administrator. The court also found that the plaintiff's claims were not barred by the statute of limitations.
• Richards v. Hartford Life & Accident Ins. Co.
  356 F. Supp. 2d 1278· S.D. Fla.· 2004-12-01 ·cited 2×
  The court held that Hartford's denial of long-term disability benefits was not "wrong" under a de novo review, and therefore affirmed the grant of summary judgment for the defendants.
• Hagberg v. Liberty Life Assurance Co. of Boston
  321 F. Supp. 2d 1270· N.D. Fla.· 2004-03-23 ·cited 2×
  The court held that Liberty's denial of long-term disability benefits was wrongful because, despite a reasonable basis for the decision, it was tainted by self-interest under the heightened arbitrary and capricious standard.
• Wall v. Pennzoil-Quaker States Co.
  358 F. Supp. 2d 1169· S.D. Fla.· 2004-01-27 ·cited 2×
  The court held that the Plan Administrator's decision to deny benefits was reasonable and supported by the evidence, and that MetLife was not the proper defendant as Pennzoil retained ultimate fiduciary responsibility.
• Hawkins v. Arctic Slope Reg'l Corp.
  344 F. Supp. 2d 1331· M.D. Fla.· 2002-09-26 ·cited 2×
  The court held that discovery in ERISA cases is generally limited to the administrative record, but may extend to issues of conflict of interest to determine the standard of review.
• Schreck v. Reliance Standard Life Ins.
  104 F. Supp. 2d 1373· S.D. Fla.· 2000-06-29 ·cited 2×
  The court held that the insurance administrator's denial of benefits was arbitrary and capricious due to a lack of adequate investigation into the circumstances of the insured's death.
• Curran v. Abbott Labs. Extended Disability Plan
  331 F. Supp. 2d 1376· M.D. Fla.· 2004-07-09 ·cited 1×
  The court held that the plan administrator's decision to deny long-term disability benefits was not wrong, and therefore summary judgment for the defendant was granted.
• Freling v. Reliance Standard Life Ins.
  315 F. Supp. 2d 1277· S.D. Fla.· 2004-02-24 ·cited 1×
  The court held that the insurer's interpretation of 'regular occupation' was not reasonable because it failed to consider the specific nature of the insured's actual occupation as practiced, instead relying solely on broad Dictionary of Occupational Titles definitions.
• Lake v. Hartford Life & Accident Ins.
  320 F. Supp. 2d 1240· M.D. Fla.· 2004-01-13 ·cited 1×
  The court held that the insurer's denial of long-term disability benefits was not "wrong" under the heightened arbitrary and capricious standard, as the plaintiff's functional capacity evaluation indicated she could perform sedentary work.
• Jordan v. Metro. Life Ins.
  205 F. Supp. 2d 1302· M.D. Fla.· 2002-05-21 ·cited 1×
  The court held that the denial of long-term disability benefits was not arbitrary and capricious, as the plan granted the administrator discretionary authority and the denial had a rational basis in the facts known at the time.
• Millman v. Kemper Nat. Servs. Plantation
  147 F. Supp. 2d 1329· S.D. Fla.· 2001-05-24 ·cited 1×
  The court held that the plan administrator's decision to terminate disability benefits was not unreasonable and was supported by a reasonable basis in the evidence.
• Street v. Aetna Life Ins. Co.
  M.D. Fla.· 2016-05-23
  The court granted summary judgment for the defendants, finding that the denial of long-term disability benefits was not wrong under a de novo standard of review.
• Miller v. Liberty Life Assur. Co. of Boston
  622 F. Supp. 2d 1284· M.D. Fla.· 2008-10-08
  The court held that Liberty Life's decisions to treat the plaintiff's injuries as separate and to terminate his LTD benefits were not demonstrably wrong and were reasonable under the arbitrary and capricious standard of review.
• Creel v. Wachovia Corp.
  543 F. Supp. 2d 1298· M.D. Fla.· 2008-02-25
  The court held that the defendant's decision to terminate long-term disability benefits was not demonstrably wrong under the plan's terms, even if potentially unfair, because the plaintiff failed to provide sufficient objective medical evidence of a disabling physical condition a
• Borschel v. Cont'l Cas. Co.
  536 F. Supp. 2d 1294· S.D. Fla.· 2008-02-13
  The court held that the plaintiff's claim for long-term disability benefits was untimely and that she failed to rebut the presumption of prejudice, thus the denial of benefits was not 'de novo wrong' under ERISA.
• Sanzone v. Hartford Life & Accident Ins.
  519 F. Supp. 2d 1250· S.D. Fla.· 2007-10-16
  The court granted reconsideration, finding that the heightened arbitrary and capricious standard applies, which limits review to the administrative record, and therefore denied the plaintiff's motion to supplement the record with a physician's affidavit.
• Manning v. Johnson & Johnson Pension Comm.
  504 F. Supp. 2d 1293· M.D. Fla.· 2007-05-16
  The court found that the Pension Committee's denial of long-term disability benefits was not arbitrary and capricious, as there was a reasonable basis in the administrative record for the decision, despite some conflicting medical opinions.
• Lyncker v. Johnson & Johnson Pension Comm.
  505 F. Supp. 2d 1303· M.D. Fla.· 2006-10-23
  The court held that the denial of long-term disability benefits based on the plaintiff's asthmatic and pulmonary conditions was arbitrary and capricious, as the administrator failed to accurately represent the treating physician's opinion and did not conduct further review.
• Buonincontri v. Liberty Life Assur. Co. of Boston
  424 F. Supp. 2d 1302· M.D. Fla.· 2006-03-10
  The court granted summary judgment for the defendant, finding the plaintiff's disability predated her long-term disability coverage and was a pre-existing condition.
• Featherston v. Metro. Life Ins.
  389 F. Supp. 2d 1302· N.D. Fla.· 2005-09-20
  The court held that the defendant insurance company's motion for summary judgment should be granted because the plaintiff failed to present sufficient evidence that she was disabled from all occupations under the terms of the ERISA plan.
• Williams v. Bd. of Trs. of the Int'l Longshoremen's Ass'n
  388 F. Supp. 2d 1353· S.D. Fla.· 2005-09-15
  The court held that the former wife was not entitled to the single death benefit because the plan language unambiguously excluded former spouses covered by a QDRO, and she failed to show detrimental reliance on any alleged misinterpretations.
• Blankenship v. SMITHkLINE Beecham Corp.
  395 F. Supp. 2d 1162· S.D. Fla.· 2005-09-06
  The court held that the defendant's motion for summary judgment is granted because the administrator's decision to terminate benefits was not arbitrary and capricious, even under a heightened standard, given the independent medical examination.
• Normil v. Colonial Life & Accident Ins.
  403 F. Supp. 2d 1159· S.D. Fla.· 2005-08-15
  The court held that the denial of benefits was not arbitrary and capricious because the insurer reasonably relied on information from the employer that the insured had terminated employment, and the insured's contrary claims were not part of the administrative record.
• Porter v. Smithkline Beecham Corp.
  373 F. Supp. 2d 1306· M.D. Fla.· 2005-05-31
  The court held that the defendant's interpretation of the plan granting it authority to request an independent medical examination during the appeals process was reasonable, and the plaintiff's refusal to submit to such an examination justified the termination of her long-term di
• Corkill v. Hartford Life & Accident Ins.
  435 F. Supp. 2d 1192· N.D. Fla.· 2005-04-28
  The court held that the defendant's denial of disability benefits was not wrong, as the plaintiff failed to provide satisfactory proof of continued disability based on objective evidence.
• Harman v. Cont'l Airlines
  371 F. Supp. 2d 1377· S.D. Fla.· 2005-04-21
  Continental Stevedoring & Terminals, Inc. appealed a second final judgment, arguing the trial court failed to follow a prior appellate mandate regarding a buy-sell offer and non-compete provision in their joint venture agreement.
• Baker v. Hartford Life & Accident Ins. Co.
  371 F. Supp. 2d 1352· M.D. Fla.· 2005-04-21
  The court held that the plan administrator's denial of long-term disability benefits was not wrong, as it was based on a reasonable interpretation of the plan and the evidence presented.
• Hallford v. Metro. Life Ins.
  367 F. Supp. 2d 1353· N.D. Fla.· 2005-03-11
  The court held that the plan administrator's denial of long-term disability benefits was not arbitrary and capricious, as it was based on substantial evidence and a reasonable interpretation of the plan's terms.
• Dowling v. Metro. Life Ins.
  355 F. Supp. 2d 1311· M.D. Fla.· 2004-12-28
  The court held that the defendant's termination of long-term disability benefits was not arbitrary and capricious, as it was supported by reasonable grounds and medical opinions.
• Rosser-Monahan v. Avon Prods., Inc.
  143 F. Supp. 492· M.D. Fla.· 2004-11-18
  The court held that discovery in ERISA cases applying the arbitrary and capricious standard should not be limited solely to the administrative record, but can include other facts known to the administrator.
• Smith v. Reliance Standard Life Ins.
  350 F. Supp. 2d 993· S.D. Fla.· 2004-09-09
  The court held that the insurer's denial of long-term disability benefits was wrong because the plaintiff was unable to perform the material duties of his regular occupation, and the insurer's interpretation of the policy terms was unreasonable.
• Mazzacoli v. Cont'l Cas. Co.
  322 F. Supp. 2d 1376· M.D. Fla.· 2004-06-22
  The court held that limited discovery outside the administrative record is appropriate to determine the standard of review, as issues regarding the delegation of discretionary authority and the actual decision-maker remain unclear.
• O'Reardon v. Principal Life Ins.
  301 F. Supp. 2d 1323· M.D. Fla.· 2004-01-03
  The court held that the insurance policy's definition of 'hospital' unambiguously required the facility to be licensed as such by the state, and therefore, treatment at a facility not licensed as a hospital was not covered.
• Kirk v. Metro. Life Ins.
  331 F. Supp. 2d 1361· M.D. Fla.· 2003-07-22
  The court held that the denial of disability benefits was not arbitrary and capricious because there was a rational basis for the decision, supported by objective medical evidence and conflicting physician opinions within the administrative record.