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The Conflict of Interest Inherit in Administrative Review

d grant of discretion, in order for the administrator to be able to use his/her discretion to interpret and construe plan terms and provisions. Jacobs v. Picklands Mather & Co., 886 F.2d 182 (8th Cir 1989). In Jacobs, former employees sued to recover benefits under an ERISA governed plan. The court found that since the plan did not specifically grant the administrator discretion to construe plan terms or to determine eligibility for benefits, the court had to review the actions as if the administrator was granted no discretion. As a result, the court granted a de novo review. The Eighth Circuit required an explicitly tailored grant of discretionary power to the administrator to construe ambiguous plan language before the court will apply a differential review. Id. at 656. As seen in Jacobs, a generic, non-explicit provision that gives a trustee final authority to determine “all matters of eligibility for the payment of claims,” is not specific enough to avoid a de novo review.Another case out of the Eighth Circuit demonstrates the “flexible” approach in comparison to the “strict” interpretation. In Woo v. Deluxe Corp., a former employee sued his employer and plan administrator seeking review of a denial of both long and short-term disability benefits. On appeal, the Eighth Circuit held that less differential than de novo standard of review applied to the administrator’s denial of disability benefits, and when an ERISA plan administrator is operating under a conflict of interest, the sliding scale standard of review applies. Woo v. Deluxe Corp., 144 F.3d 1157 (8th Cir. 1998). Under this “sliding scale” or “flexible” approach, the court will continue to review for an abuse of discretion but will decrease the deference given to an administrator in proportion to the seriousness of the conflict. Id. The court stated that Woo was “required to present evidence...

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