Second Circuit Narrows ERISA Exhaustion Requirement When Plan Document Is Ambiguous on Need to Follow Claims Procedures

By on February 20, 2013

by Michael T. Graham, Elizabeth A. Savard and Patrick D. Ryan

The U.S. Court of Appeals for the Second Circuit’s holding in Kirkendall v. Halliburton, Inc. reaffirms that a benefit plan’s claims procedures must be drafted clearly and in language to be understood by a reasonable participant.  If participants are permitted to avoid a plan’s administrative claims process, there are significant impacts on a plan’s defense of a lawsuit, including application of a de novo standard of review to a benefit determination rather than the deferential arbitrary and capricious standard.

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