United States Fourth Circuit

In a case under ERISA, plan administrator's findings that a procedure to correct a child's skull deformity was "cosmetic" and not a medical necessity were objectively unreasonable and not supported by substantial evidence, and denial of benefits was improper.

Appellate Information

• Argued 01/22/2002
• Decided 04/19/2002
• Published 04/19/2002

Judges

• Before WILLIAMS and KING, Circuit Judges, and CYNTHIA HOLCOMB HALL, Senior Circuit Judge of the United States Court of Appeals for the Ninth Circuit, sitting by designation.

Court

• United States Fourth Circuit

Counsel

• For Appellees:
  
• ARGUED:  Mark Stanton Thomas, Maupin, Taylor & Ellis, P.A., Raleigh, North Carolina, for Appellant.  Robert Edward Hoskins, Foster & Foster, L.L.P., Greenville, South Carolina, for Plaintiff-Appellee.   ON BRIEF:  Joanne J. Lambert, Maupin, Taylor & Ellis, P.A., Raleigh, North Carolina, for Defendant-Appellant.