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Home / Courts / Insurance – Long-Term Disability – ERISA – ‘Full & Fair Review’ – Denial Letter – Reference to Different Claimant (access required)

Insurance – Long-Term Disability – ERISA – ‘Full & Fair Review’ – Denial Letter – Reference to Different Claimant (access required)

Cole v. Aetna Life Insurance Co. Where the defendant-insurer’s letter denying plaintiff’s claim for long-term disability benefits consisted of one-third boilerplate, one-third references to a different claimant, and one-third direct quote from the consulting physician, it does not appear that plaintiff received the full and fair review required by ERISA. The court grants plaintiff’s motion to remand for reconsideration with supplemental evidence.

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