Opinion
Case No. 15-cv-04235-VC
11-02-2016
JESSICA LANGRIDGE, Plaintiff, v. U.S. ROCHE HEALTH AND WELFARE BENEFITS VEBA PLAN, Defendant.
ORDER RE STANDARD OF REVIEW
Re: Dkt. No. 28
The defendant has failed to overcome the default presumption that a de novo standard of review applies in ERISA denial-of-benefits cases. See Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989). The Genentech benefits plan didn't vest the claims administrator - the entity that actually denied Langridge's claim - with discretion to interpret the plan's terms. The plan vested the plan administrator with that power, and the plan administrator never properly delegated it. Taylor Decl., Ex. A (Dkt. 28-2) at 73-74; cf. Shane v. Albertson's Inc., 504 F.3d 1166, 1170 (9th Cir. 2007). The defendant points to a provision in the plan description requiring claimants to "submit requested proof of continuing Disability . . . satisfactory to the Claims Administrator within the time period specified by the Claims Administrator." Supp. Taylor Decl., Ex. A (Dkt. 32-2) at 1358. But this suggests a delegation of administrative discretion - the limited authority to decide what records are acceptable, or to set a quantum of proof - rather than the broader power to interpret the plan's terms. See Kearney v. Standard Ins. Co., 175 F.3d 1084, 1089 (9th Cir. 1999). And in any event, ERISA requires more than an implication to displace de novo review.
IT IS SO ORDERED. Dated: November 2, 2016
/s/_________
VINCE CHHABRIA
United States District Judge