Gibbs Design
In Montour v. Hartford Life & Accident Ins. Co., 582 F.3d 933 (September 14, 2009), the Ninth Circuit determined that a conflict of interest heavily influenced the benefits decision and ruled for plaintiff. Specifically, the Court pointed to the administrator’s bias in advocating its position that the claimant was not disabled, its reliance on surveillance...
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In Dupree v. Holman Professional Counseling Centers, 572 F.3d 1094 (July 29, 2009), the Ninth Circuit followed the language of the ERISA plan in determining that there was no coverage under a health insurance plan for non-emergency services at a non-contracted facility. The Ninth Circuit ruled that the clear language of the ERISA plan repeatedly...
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