Doesn ERISA impose fiduciary duties upon the plan administrator (or insurer) in processing my claim for benefits?
Yes. ERISA imposes “fiduciary” responsibilities on anyone, who exercises final decision-making authority over plan benefits. Unfortunately, however, in the field of ERISA law, “fiduciary duty” means little. The main problem is that the way the courts have construed ERISA, nothing prohibits ERISA fiduciaries, from operating under a “conflict of interest”. As stated above, under the most basic concepts of trust law, a fiduciary’s interest is not supposed to conflict with that of the “beneficiary”. However, under ERISA law, such conflicts of interest are expected and to some extent even condoned. This is the ultimate paradox of ERISA.
