Mizzell

Memorandum of Decision re Standard of Review and Related Issues

At a hearing on June 9, 2003, the Court requested that the parties brief two separate but somewhat interrelated issues:

What standard of the review is the Court to apply in reviewing a decision to deny disability coverage made by a plan administrator under a plan governed by ERISA9

Must the Court’s decision be made exclusively on the basis of the administrative record before the plan administrator, or is plaintiff Mizzell entitled to supplement the record through discovery?

As explained below, the Court concludes that with respect to Paul Revere, the appropriate standard of review is “abuse of discretion,” and that the Court’s review must be based exclusively on the administrative record. The Court reaches the same conclusion with respect to Hartford to the extent that its denial was predicated on any ground other than untimeliness. The Court concludes that review of Hartford’s decision to deny Mizzell’s claim as untimely should be de novo. Mizzell is entitled to limited discovery on the untimeliness defense and the “notice-prejudice” rule.

I. Standard of Review.

Plaintiff Terry Mizzell (“Mizzell”) claims…