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Proof of Loss Language in Disability Policy Not Enough to Enable Abuse of Discretion Standard (PDF)
U.S. Court of Appeals for the Sixth Circuit 
[Opinion] June 10, 2002 Hoover v. Provident Life and Accident Insurance Company (No. 00-5796, 6th Cir. 2002). Excerpt: The requirement that the insured submit written proof of loss, without more, does not contain 'a clear grant of discretion [to Provident] to determine benefits or interpret the plan.' ... The policies do not expressly state that the administrator has discretion over the determination of residual benefits, nor is there language requiring 'satisfactory' proof of a disability. MORE >> |
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