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NEUROLOGICAL RESOURCES v. ANTHEM INS. COMPANIES

No. IP 97-1158-C H/G.

61 F.Supp.2d 840 (1999)

NEUROLOGICAL RESOURCES, P.C., Plaintiff, v. ANTHEM INSURANCE COMPANIES d/b/a Blue Cross/Blue Shield, Defendant.

United States District Court, S.D. Indiana, Indianapolis Division.

August 17, 1999.

Attorney(s) appearing for the Case

Robert G. Zeigler, Zeigler Carter Cohen & Koch, Indianapolis, IN, for plaintiff.

Thomas G. Stayton, Baker & Daniels, Indianapolis, IN, Joseph F. Pieters, Anthem, Inc., Indianapolis, IN, for defendant.

HAMILTON, District Judge.

This action presents important and recurring questions about the standards that courts apply when reviewing decisions to deny benefits under employee benefit plans governed by the federal Employees Retirement Income Security Act (ERISA). The issues are whether standard terms in group health insurance plans that do not explicitly grant discretionary power to a plan administrator to construe ambiguous terms or to determine eligibility for benefits...

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