Raymond Vaught v. Scottsdale Healthcare Corporat, No. 09-17561 (9th Cir. 2011)
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FILED NOT FOR PUBLICATION UNITED STATES COURT OF APPEALS JAN 10 2011 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS FOR THE NINTH CIRCUIT RAYMOND VAUGHT, Plaintiff - Appellant, No. 09-17561 D.C. No. 2:05-CV-00718-DGC v. MEMORANDUM* SCOTTSDALE HEALTHCARE CORPORATION HEALTH PLAN, Defendant - Appellee. Appeal from the United States District Court for the District of Arizona David G. Campbell, District Judge, Presiding Argued and Submitted December 8, 2010 San Francisco, California Before: HUG, D.W. NELSON, and McKEOWN, Circuit Judges. Raymond Vaught appeals the district court s judgment that the Scottsdale Healthcare Corporation Health Plan (the Plan ) properly denied his claim for medical expenses under a provision excluding coverage of accidents related to driving under the influence of alcohol or drugs (the DUI Provision ). The district * This disposition is not appropriate for publication and is not precedent except as provided by 9th Cir. R. 36-3. court s decision was based on the administrative record, but also noted that the court had previously determined that the introduction of extrinsic evidence was appropriate under Mongeluzo v. Baxter Travenol Long Term Disability Benefit Plan, 46 F.3d 938, 943-44 (9th Cir. 1995). We have jurisdiction under 28 U.S.C. ยง 1291. We review de novo the district court s choice and application of the standard of review to decisions by fiduciaries of an employee benefit plan subject to the Employee Retirement Income Security Act ( ERISA ), and for clear error the district court s underlying findings of fact. Abatie v. Alta Health & Life Ins. Co., 458 F.3d 955, 962 (9th Cir. 2006) (en banc) (citations omitted). We also review de novo the district court s legal conclusions in interpreting provisions of an ERISA benefit plan. Metro. Life Ins. Co. v. Parker, 436 F.3d 1109, 1113 (9th Cir. 2006) (citations omitted). For the reasons stated in its well-crafted order, the district court properly interpreted the DUI Provision in Vaught s favor to exclude coverage of accidents related to driving while legally intoxicated; found that Vaught, whose whole blood alcohol level was almost three times the state s legal limit, was legally intoxicated at the time of his motorcycle accident; and determined after de novo review that the Plan s denial of Vaught s medical expenses was proper. AFFIRMED. 2 09-17561
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