Opinion ID: 2976436
Heading Depth: 3
Heading Rank: 2

Heading: Plan’s Appeal Provision

Text: We first consider Huffaker’s argument that MetLife should have considered evidence she submitted to MetLife following its denial of her appeal on February 10, 2005. She contends that MetLife acted arbitrarily in closing the record, given that the Plan “does not explicitly limit MetLife to considering only one appeal.” Although Huffaker is correct that the Plan does not expressly limit MetLife to considering one appeal, the Plan conversely does not allow a claimant to take an unlimited or even a specified number of appeals. The Plan provides for “a review of claims denied in whole or in part.” Because the Plan treats a claimant’s right to appeal as a singular noun (“a review of claims”), MetLife did not act arbitrarily in interpreting the Plan to permit only one appeal. We find persuasive the Fifth Circuit’s holding that “the complete description of the process for one appeal without mentioning a second appeal clearly implies that only one appeal is allowed.” Hilton v. Ashland Oil Inc., No. 96-40100, 1996 WL 731358, at  (5th Cir. Nov. 11, 1996). -8- MetLife’s correspondence with Huffaker is consistent with its contention that Huffaker was entitled to only one appeal. In its initial denial letter, MetLife advised Huffaker that she could appeal by filing a written request within 180 days, and that she should include “any additional comments, documents, records or other information relating to your claim that you deem appropriate for us to give your appeal proper consideration.” The denial letter goes on to state: “[i]n the event that your appeal is denied in whole or in part, you will have the right to bring a civil action” under ERISA. Thus, by the explicit terms of this correspondence, Huffaker was advised that she must submit all evidence deemed relevant by her in her appeal of MetLife’s benefits determination. The correspondence made clear that the next tier of review after her appeal was not a second internal appeal for MetLife’s consideration, but an ERISA action in federal court.