The answer is clear “where it is the employer that both funds the plan and evaluates the claims. In such a circumstance, every dollar provided in benefits is a dollar spent by the employer; and every dollar saved is a dollar in the employer’s pocket. The employer’s fiduciary interest may counsel in favor of granting a borderline claim while its immediate financial interest counsels to the contrary. Thus, the employer has an interest conflicting with that of the beneficiaries. The answer to the conflict question is less clear where (as here) the plan administrator is not the employer itself but rather a professional insurance company. Conceding these differences, we nonetheless continue to believe that for ERISA purposes a conflict exists. We do not believe that Firestone’s statement implies a change in the standard of review, say, from deferential to de novo review. Neither do we believe it necessary or desirable for courts to create special burden-of-proof rules, or other special procedural or evidentiary rules, focused narrowly upon the evaluator/payor conflict. In principle, conflicts are but one factor among many that a reviewing judge must take into account. Benefits decisions arise in too many contexts, concern too many circumstances, and can relate in too many different ways to conflicts-which themselves vary in kind and in degree of seriousness-for us to come up with a one-size-fits-all procedural system that is likely to promote fair and accurate review. We believe that Firestone means what the word ‘factor’ implies, namely, that when judges review the lawfulness of benefit denials, they will often take account of several different considerations of which a conflict of interest is one.” Met Life v. Glenn, 128 S.Ct. 2343 (2008).
0 Comments