United States Fourth Circuit

Judgment that an ERISA administrator abused its discretion in denying plaintiff a cochlear implant is affirmed where: 1) the exclusion language relied on by defendant was ambiguous; 2) defendant's interpretation of the language was inconsistent with several other provisions in the ERISA plan; and 3) defendant failed to construe the ambiguous language against the drafting party. Award of attorney's fees is reversed where a court cannot rely solely on an administrator's improper denial of coverage on a single claim to support an award of fees to a claimant.

Appellate Information

• Decided 10/23/2006
• Published 10/23/2006

Judges

• Before MOTZ and GREGORY, Circuit Judges, and RICHARD L. VOORHEES, United States District Judge for the Western District of North Carolina, sitting by designation.

Court

• United States Fourth Circuit

Counsel

• For Appellees:
  
• Jeffrey Stuart Patterson, Nelson, Mullins, Riley & Scarborough, L.L.P., Columbia, South Carolina, for Appellant.  Charles M. Gibson, Jr., Charleston, South Carolina, for Appellee.