Please read our Copyright Notice and Disclaimers before you use this resource.
“… [t]here is a qualitative difference between determining the sufficiency of a claim that a participant is disabled, and determining whether, under the defined terms of a contract, a participant is eligible for benefits. The former involves a subjective judgment as to the sufficiency and veracity of the claim presented, whereas the latter involves objective contractual interpretation. … When the plan itself has granted the administrator the discretion to subjectively evaluate the sufficiency of a claim for benefits, the administrator's decision should be given some deference. Otherwise, the administrator's decision should be reviewed de novo.
In the present case, rather than requiring the plan administrator to exercise subjective judgment to determine whether a claim is sufficient, the SERP merely requires the plan administrator to interpret the contract and grant benefits when its defined terms have been met. Therefore, the appropriate standard of review is de novo.
Armstrong v. Great Lakes Higher Education Corporation, 2002 WL 459077 (D. Minn. Mar. 18, 2002)- The “… Plan provides in relevant part that "[n]othing in this document is intended to ... restrict the Corporation's right to ... interpret the provisions of this Plan." … Although this language is not as unequivocal as some cited above, it is far more discretion-granting than the standard policy terms that trigger de novo review under Eighth Circuit case law. Therefore, this Court holds that the Plan explicitly grants discretion to Great Lakes, and that the Court should therefore review Great Lakes' interpretation under the abuse-of-discretion standard.
