No. 18-1266

Timothy P. O'Leary v. Aetna Life Insurance Company

Lower Court: Eleventh Circuit
Docketed: 2019-04-02
Status: Denied
Type: Paid
Tags: adverse-benefits-determination arbitrary-capricious benefits-determination civil-procedure claims-procedures department-of-labor erisa erisa-statute erisa-statute-and-regulations fiduciary-duties fiduciary-duty standard-of-review
Latest Conference: 2019-06-06
Question Presented (from Petition)

This petition presents one legal issue in two parts that have divided the courts of appeals regarding ERISA statute and regulations. Congress intended for fiduciaries to comply with ERISA statute and regulations to protect plan beneficiaries. Congress explicitly authorized the Department of Labor to police fiduciaries, implement regulations, authorize action for beneficiaries and courts upon fiduciary misconduct, all with the goal of protecting beneficiaries especially during benefit determinations.

O'Leary's questions are premised on an ERISA adverse benefits determination, when the fiduciary has discretionary authority over the plan and initially given deference by the court and the standard of review is deferential (arbitrary and capricious) but then it is revealed that the fiduciary failed to comply with ERISA statute and regulations claims-procedures textual requirements thus failing to provide a "full and fair review" of the claim which are codified in 29 C.F.R. § 2560.503-1.

The Questions Presented Are:

1. Does a fiduciary who is given deference "entitle" the fiduciary's decision priority over compliance with ERISA statute and regulations or does compliance have priority over fiduciary's decision and if found in violation of compliance with claims-procedures, is fiduciary's decision "arbitrary and capricious"?

2. Does a fiduciary lose its deference and the standard of review revert back to de novo, when claimsprocedures are violated as directed by the Department of Labor and held by the Second Circuit?

Question Presented (AI Summary)

Does a fiduciary's decision take priority over compliance with ERISA statute and regulations?

Docket Entries

2019-06-10
Petition DENIED.
2019-05-21
DISTRIBUTED for Conference of 6/6/2019.
2019-05-16
Reply of petitioner Timothy P. O'Leary filed.
2019-05-02
Brief of respondent Aetna Life Insurance Co. in opposition filed.
2019-03-29
Petition for a writ of certiorari filed. (Response due May 2, 2019)
2019-01-24
Application (18A751) granted by Justice Thomas extending the time to file until March 29, 2019.
2019-01-15
Application (18A751) to extend the time to file a petition for a writ of certiorari from January 29, 2019 to March 29, 2019, submitted to Justice Thomas.

Attorneys

Aetna Life Insurance Co.
Jerel Charles DawsonShutts & Bowen LLP, Respondent
Timothy P. O'Leary
Timothy P. O'Leary — Petitioner