Conflict of Interest

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ERISA: Third Circuit – Third Party Administrator of Self-Funded Plans Gets Discretionary Review

By Mike Reilly on August 17, 2011

Posted in ERISA

Here is a case update on two important ERISA issues:

1. Does “conflict of interest” apply to third-party administrators of self-funded plans? Claimants may argue that de novo review applies to third party claim administrators (TPA) of self-funded plans due to a conflict of interest.

They will claim the TPA is in such a “competitive

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3rd Circuit: Abuse of Discretion and Considering Evidence Outside the Administrative Record

By Mike Reilly on September 3, 2010

Posted in ERISA

So what can a court consider, in determining whether a conflict of interest affected the benefit denial?

Can a court consider evidence outside of the administrative record to assess the potential bias of the decision-maker in a case involving conflict of interest? YES

Here is Howley v. Mellon Financial Plan et al, __ F.…

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Conflict of Interest

ERISA: Third Circuit – Third Party Administrator of Self-Funded Plans Gets Discretionary Review

3rd Circuit: Abuse of Discretion and Considering Evidence Outside the Administrative Record

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