Bruce M. v. Aetna Life Insurance Company (U.S. Dist. Ct., Dist. of UT, case no. 2:20-cv-00346-DBB, Nov 24, 2021). In this case, Judge David Barrow denied Defendant’s summary judgement motion and ruled that Aetna’s denial of benefits was arbitrary and capricious under ERISA. Case involved an 11-year old dependent that stayed at a RTC for 15 months, with Aetna covering only about 20 days using its Level of Care Tool (LOCAT). Plaintiffs filed two internal appeals and one external appeal (with MRIoA), all of which upheld Aetna’s denial of benefits for the balance of the child’s stay. In the court analysis, Judge Barrow reviewed the criteria for a “de novo” review (e.g., such as based on procedural irregularities), but rejected Plaintiff’s claims that Aetna and MRIoA failed to: 1) explain the basis for the denial; 2) take into account key information in the record; 3) engage in meaningful dialogue; and 4) provide additional material or information to perfect the Plaintiff’s claim. However, Judge Barrow remanded the case under the arbitrary and capricious standard of review because Aetna and MRIoA failed to take into account key issues associated with the child, including potential danger to himself and others around him. Attorney fees and costs were awarded to the Plaintiffs but prejudgment interest was not.