The Insurance Company’s Conflict of Interest

A Court must take into consideration the conflict of interest inherent in a benefits system in which the entity that pays the benefits maintains discretionary control over the ultimate benefits decision. See, Metropolitan Life Insurance Company v. Glenn, 554 U.S. 105, 112 (2008).  This is done by weighing the structural conflict as one of the many factors relevant to the benefits determination decision. However, this conflict of
interest will not be a significant factor a case where the plaintiff has not come forward with any evidence that the conflict influenced the benefits decision, the employer employed a third-party benefits administrator, and the administrator consulted independent experts in reviewing the claim.

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