Was The Insurance Company's Decision Reasonable?

Was the insurance company's decision reasonable?To determine whether the administrator's decision was reasonable and based on substantial evidence, the Fourth Circuit has formulated a nonexhaustive 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