"Why Your Employer's Long-Term Disability Plan May be a Scam"
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What factors does a reviewing Court look at to determine whether an insurance company's decision under an ERISA disability policy was reasonable?

 

A: To determine whether the administrator's decision was reasonable and based on substantial evidence, the Fourth Circuit has formulated a non exhaustive list of eight factors that a court may consider. Booth v. Wal Mart Stores, Inc., 201 F.3d 335 (4th Cir. 2000). Those factors are:

1. The language of the plan;
2. The purpose and goals of the plan;
3. The adequacy of the materials considered to make the decision and the degree to which they support it;
4. Whether the decision making process was recent and principled;
5. Whether the decision comports with other provisions in the plan and with earlier interpretations of the plan;
6. Whether the decision was consistent with the procedural and substantive requirements of ERISA;
7. Any external standard relevant to the exercise of discretion; and
8. The administrator's motives or any conflicts of interest it may have.