Eric P. v. Directors Guild of America

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 ERIC P., Case No. 19-cv-00361-WHO

8 Plaintiff,

ORDER ON STANDARD OF REVIEW

v. 9 Re: Dkt. No. 37 10 DIRECTORS GUILD OF AMERICA, et al., Defendants. 11

12 Plaintiff seeks review of the Directors Guild of America-Producer Health Plan’s decision 13 denying his claim of coverage for residential mental health treatment for his daughter. The 14 question at issue here is what standard of review – de novo or abuse of discretion – applies to my 15 review of the Plan’s denial. Plaintiff argues de novo review is appropriate, despite the discretion 16 provided to the Trustees of the Plan and through them to the Benefits Committee under the terms 17 of the Plan, because: (1) because the Plan documents granted deference to so many entities 18 involved in the claim-decision process, that grant is “anything but clear and unambiguous,” as 19 required in the Ninth Circuit; (2) the Trust documents do not provide deferential decision-making 20 authority over claims to the Benefits Committee that made the final…