United States Sixth Circuit

In plaintiff's case against a benefit plan administrator for denying its claim for benefits under ERISA, district court's judgment is affirmed in part and reversed in part where: 1) district court did not err in applying the de novo standard of review in concluding that the third-party administrator for the plan rather than defendant made the decision to deny the claim for benefits; 2) district court properly concluded that defendant erred in denying the claim as the court correctly determined that the benefits for which the claimant sought payment did not stem from a loss caused by driving without a license and driving without insurance, for purposes of an exclusionary clause in the plan; 3) district court properly awarded benefits and prejudgment interest to plaintiff; and 4) award of attorney's fees is reversed as the district court erred in weighing the first factor of the five-factor test in favor of a fees award.

Appellate Information

• Argued 06/16/2009
• Decided 09/22/2009
• Published 09/22/2009

Judges

• Before CLAY and ROGERS, Circuit Judges; JORDAN, District Judge.

Court

• United States Sixth Circuit

Counsel

• For Appellees:
  
• ARGUED:David A. Thornton, Bass, Berry & Sims PLC, Memphis, Tennessee, for Appellant. Curtis Henry Goetsch, McCullough & McCullough, PLLC, Germantown, Tennessee, for Appellee. ON BRIEF:David A. Thornton, Colleen D. Hitch, Bass, Berry & Sims PLC, Memphis, Tennessee, John R. Kirk, Bass, Berry & Sims PLC, Nashville, Tennessee, for Appellant. Curtis Henry Goetsch, McCullough & McCullough, PLLC, Germantown, Tennessee, for Appellee.