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

Question 52

Multiple Choice

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.In making its decision,how would a court likely address Jan's claim of a conflict of interest?


A) Since the employer is not the plan administrator,there is no conflict of interest.
B) A conflict of interest would be found to exist,but it would be given no weight by the court.
C) The conflict would be weighted as a factor in the court's decision.
D) The conflict would result in de novo review and a requirement that the administrator justify its decision by clear and convincing evidence.

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