Monday, November 15, 2004
The Second Circuit held that such a conflict, in and of itself, did not per se constitute good cause to consider evidence outside of the administrative record. Such a rule would allow a plaintiff to add evidence to the record in almost every case because the administrator of the benefits plan is always linked to the insurer. However, in this case, there were no written procedures for claims review, and the Court held that the lack of such procedures exacerbated the conflict, rendering it proper for the District Court to have considered the new evidence.
The Court then looked to the evidence and held that it was sufficient to justify the District Court's finding. The Court also upheld the District Court's award of attorneys' fees.
The decision in Locher v. Unum Life Insurance Co. can be found here.