Fact Pattern 14-2 Jan Is a Participant in an Employer Sponsored Disability Insurance

Fact pattern 14-2
Jan is a participant in an employer sponsored disability insurance plan.Her former employer,Generous,provided the plan; and it was administered by ABC Insurance Co.Jan was initially awarded benefits a few years ago based upon a back problem.Her ex-husband,however,reported to the plan administrator that Jan was not really disabled and that she was engaged in the following activities with her new boyfriend: horseback riding,dancing the tango,scuba diving,and mountain climbing.After investigation,ABC promptly discontinued her disability benefits.Jan calls up the plan administrator and says that she is having significant back problems,that her ex-husband and ABC's private investigators are all liars,and that she is going to sue.Jan says that both Generous and ABC are biased and that all they want to do is save money,not take care of the disabled.Jan says that a federal court will straighten out the plan administrator's conflict of interest.
-Refer to fact pattern 14-2.Which of the following will the court consider in determining whether a de novo or deferential standard of review is appropriate when reviewing the decision of the plan administrator?

A) Whether the plan grants the administrator discretionary authority making benefit determinations.
B) How many times the administrator has denied benefits in the past 12 months.
C) The size of the plan.
D) All of the responses are correct.

Correct Answer:

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