What factors does a reviewing Court look at to determine whether an insurance company's decision under an ERISA disability policy was reasonable?

To determine whether the administrator's decision was reasonable and based on substantial evidence, the Fourth Circuit has formulated a non exhaustive list of eight factors that a court may consider. Booth v. Wal Mart Stores, Inc., 201 F.3d 335 (4th Cir. 2000). Those factors are:

1. The language of the plan;
2. The purpose and goals of the plan;
3. The adequacy of the materials considered to make the decision and the degree to which they support it;
4. Whether the decision making process was recent and principled; 
5. Whether the decision comports with other provisions in the plan and with earlier interpretations of the plan;
6. Whether the decision was consistent with the procedural and substantive requirements of ERISA;
7. Any external standard relevant to the exercise of discretion; and
8. The administrator's motives or any conflicts of interest it may have.

Ben Glass
Ben Glass is a nationally recognized Virginia injury, medical malpractice, and long-term disability attorney