Court Chooses ‘Could’ Over ‘Would’ In Insurance Benefits Case
March 30, 2016 by Cyril Tuohy
A circuit court has upheld an insurance company’s suspension of long-term disability benefits after the court found the insurer hadn’t met the “abuse of discretion” standard in denying disability benefits to a Minnesota doctor who suffered from the effects of a car accident and a subsequent unrelated knee injury.
When the case involves a conflict of opinion between a claimant’s treating physicians and the plan administrators’ reviewing physicians, the administrator, in this case the insurance carrier, has discretion to deny benefits “unless the record does not support denial,” the U.S. Court of Appeals for the 8th Circuit wrote.
“In resolving this conflict, Standard was not required to give special deference to the opinions of Whitley’s treating physicians,” the three-judge panel found, in a 13-page decision issued earlier this month in Gwendolyn Whitley v. Standard Insurance Company. Click HERE to view article
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