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United States Ninth Circuit


Abatie v. Alta Health & Life Ins. Co., 03-55601

In ERISA cases in which a conflict of interest exists for the plan administrator, abuse of discretion review, tempered by skepticism commensurate with the plan administrator's conflict of interest, applies. When a decision by an administrator utterly fails to follow applicable procedures, the administrator is not, in fact, exercising discretionary powers under a plan, and its decision should be subject to de novo review. Lesser irregularities do not remove the decision from abuse of discretion review, but should be factored into the calculus of whether the administrator abused its discretion.

Appellate Information

  • Argued 03/23/2006
  • Decided 08/15/2006
  • Published 08/15/2006

Judges

  • Before:  Mary M. Schroeder, Chief Judge, and Alex Kozinski, Diarmuid F. O'Scannlain, Pamela Ann Rymer, Andrew J. Kleinfeld, Barry G. Silverman, Susan P. Graber, M. Margaret McKeown, Kim McLane Wardlaw, William A. Fletcher, Ronald M. Gould, Richard A. Paez, Johnnie B. Rawlinson, Jay S. Bybee, and Consuelo M. Callahan, Circuit Judges.

Court

  • United States Ninth Circuit

Counsel

  • For Appellant:
  • Daniel Feinberg, Cassie Springer-Sullivan, Lewis, Feinberg, Renaker & Jackson, P.C., Oakland, California;  Craig Price, Griffith & Thornburgh, Santa Barbara, California, for the plaintiff-appellant., Jay E. Sushelsky, AARP Foundation Litigation, Washington, D.C.;  John Will Ongman, Barnes & Thornburg, LLP, Washington, D.C., for the amici curiae.

  • For Appellees:
  • R. Daniel Lindahl, Bullivant Houser Bailey, Portland, Oregon;  Waldemar J. Pflepsen, Jr., Jorden Burt LLP, Washington, D.C., for the defendant-appellee.
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