Jin Zhou v. Guardian Life Ins. Co. of Am., 295 F.3d 677 (7th Cir. 2002). · Go Syfert
Jin Zhou v. Guardian Life Ins. Co. of Am., 295 F.3d 677 (7th Cir. 2002). Cases Citing This Book View Copy Cite
66 citation events (66 in the last 25 years) across 14 distinct courts.
Strongest positive: Dual Diagnosis Treatment Center v. Health Care Service Corporation (ilnd, 2022-07-07)
Treatment trajectory · 2003 → 2026 · click a year to view as-of
2003 2014 2026
Top citers, strongest first. 43 distinct citers. How cited ↗
examined Cited as authority (verbatim quote) Dual Diagnosis Treatment Center v. Health Care Service Corporation (3×) also: Cited as authority (rule), Cited "see"
N.D. Ill. · 2022 · quote attribution · 1 verbatim quote · confidence high
zhou admits that he did not exhaust his administrative remedies and pursue further administrative appeals of the partial denial of his claim.
discussed Cited as authority (verbatim quote) Novosel v. Azcon In. Retirement and Benefits Committee
N.D. Ill. · 2022 · quote attribution · 1 verbatim quote · confidence high
as a pre-requisite to filing suit, an erisa plaintiff must exhaust his internal administrative remedies.
discussed Cited as authority (verbatim quote) Woodson v. Village of Steger, Illinois, The
N.D. Ill. · 2022 · quote attribution · 1 verbatim quote · confidence high
as a pre-requisite to filing suit, an erisa plaintiff must exhaust his internal administrative remedies.
discussed Cited as authority (verbatim quote) Futterman v. United Employee Benefit Fund
N.D. Ill. · 2021 · quote attribution · 1 verbatim quote · confidence high
as a pre-requisite to filing suit, an erisa plaintiff must exhaust his internal administrative remedies.
discussed Cited as authority (verbatim quote) Honeysett v. Allstate Insurance Co. (2×) also: Cited as authority (rule)
N.D. Ill. · 2008 · signal: see also · quote attribution · 1 verbatim quote · confidence high
zhou admits that he did not exhaust his administrative remedies and pursue further administrative appeals of the partial denial of his claim.
cited Cited as authority (rule) Andrew Taylor Thompson v. Pioneer Bank & Trust
D.S.D. · 2026 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002)).
cited Cited as authority (rule) BLACKLEDGE v. UNITED PARCEL SERVICE, INC.
S.D. Ind. · 2024 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002).
discussed Cited as authority (rule) Baird v. Steel Dynamics Inc. (2×) also: Cited "see"
N.D. Ind. · 2024 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002).
cited Cited as authority (rule) Huber v. IKORRC
N.D. Ind. · 2023 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002), it has cautioned that this typically happens in cases with “records significantly more plenary” than what is available at the pleading stage.
cited Cited as authority (rule) Dernis v. Federal Deposit Insurance Company
N.D. Ill. · 2022 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002)).
discussed Cited as authority (rule) Bernardo Sanchez v. Hartford Life and Accident Insurance Company (2×) also: Cited "see"
C.D. Cal. · 2022 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir. 2002). 9 The burden is on the plaintiff seeking an excuse for failure to comply with a 10 plan’s administrative procedure.
cited Cited as authority (rule) Freiermuth v. St. Paul Electrical Workers Health Plan
D. Minnesota · 2022 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002)).
discussed Cited as authority (rule) Cutrone v. The Allstate Corporation
N.D. Ill. · 2021 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir. 2002) (district court did not abuse discretion in dismissing ERISA complaint when plaintiff admitted that he did not exhaust his administrative remedies); Bingham v. CNA Fin.
discussed Cited as authority (rule) Lorek v. Lorek
N.D. Ind. · 2021 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir. 2002) (quotation marks and citation omitted). ***** Title 11 U.S.C. § 1307 (b) controls motions for voluntary dismissal in Chapter 13 cases: “On request of the debtor at any time, if the case has not been converted under section 706, 1112, or 1208 of this title, the court shall dismiss a case under this chapter . . ..” Id.
cited Cited as authority (rule) Mileusnic v. PennyMac Loan Services
N.D. Ind. · 2020 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir. 2002).
cited Cited as authority (rule) Almont Ambulatory Surgery Center, LLC v. UnitedHealth Group, Inc.
C.D. Cal. · 2015 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir.2002)) (internal quotation marks omitted).
cited Cited as authority (rule) B-3 Properties, LLC v. Lasco
N.D. Ind. · 2014 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002).
cited Cited as authority (rule) Jump v. Speedway LLC
D. Minnesota · 2014 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir.2002)).
cited Cited as authority (rule) Kutrubis v. Bowman (In re Kutrubis)
N.D. Ill. · 2013 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002) (quoting Cincinnati Ins.
cited Cited as authority (rule) Winkelspecht v. Gustave A. Larson Co.
E.D. Wis. · 2012 · confidence medium
Co. of America, 295 F.3d 677, 679 (7th Cir.2002).
cited Cited as authority (rule) Edwards v. Briggs & Stratton Retirement Plan
7th Cir. · 2011 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002) (“[W]e review a district court’s decision to dismiss a complaint on exhaustion grounds for an abuse of discretion.”).
discussed Cited as authority (rule) Craig v. Fed Ex Ground Package System, Inc. (2×)
N.D. Ind. · 2010 · confidence medium
Co. of America, 295 F.3d 677, 679 (7th Cir.2002) (stating that an ERISA plaintiff must exhaust all available administrative remedies before filing suit to challenge a denial of benefits). 1 “Congress’s apparent intent in mandating internal claims procedures found in ERISA ... was to minimize the number of frivolous lawsuits; promote consistent treatment of claims; provide a nonadversarial dispute resolution process; and decrease the cost and time of claims settlement.” Powell v. AT. & T, 938 F.2d at 826 ; see also Lindemann v. Mobil Oil Corp., 79 F.3d 647, 650 (7th Cir.1996).
discussed Cited as authority (rule) Barbara Brown v. J.B. Hunt Transport Services (2×)
8th Cir. · 2009 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir. 2002) (reviewing for an abuse of discretion); Perrino v. S. Bell Tel. & Tel.
discussed Cited as authority (rule) Brown v. J.B. Hunt Transport Services, Inc. (2×)
8th Cir. · 2009 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir.2002) (quoting Lindemann v. Mobil Oil Corp., 79 F.3d 647, 650 (7th Cir.1996)).
cited Cited as authority (rule) Richardson v. Astellas U.S. LLC Employee Benefit Plan
N.D. Ill. · 2009 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002).
cited Cited as authority (rule) Radcliffe v. International Painters & Allied Trades Industry Pension Fund (In Re Radcliffe)
N.D. Ind. · 2008 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002).
discussed Cited as authority (rule) Losinske v. Wisconsin Carpenters' Pension Fund
W.D. Wis. · 2007 · confidence medium
Although typically an ERISA plaintiff must exhaust his internal administrative remedies before filing suit, Doe v. Blue Cross & Blue Shield United of Wisconsin, 112 F.8d 869, 873 (7th Cir.1997), the exhaustion requirement does not apply “when further administrative appeal is futile.” Zhou v. Guardian Life Insurance Co. of America, 295 F.3d 677, 680 (7th Cir.2002).
cited Cited as authority (rule) Hess, James v. Reg-Ellen Employee
7th Cir. · 2007 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir. 2002).
cited Cited as authority (rule) Hess v. Reg-Ellen MacHine Tool Corp. Employee Stock Ownership Plan
7th Cir. · 2007 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002).
cited Cited as authority (rule) Taylor v. Lifetouch National School Studios, Inc.
N.D. Ind. · 2007 · confidence medium
Co. of America, 295 F.3d 677, 679 (7th Cir.2002); Doe v. Blue Cross & Blue Shield United of Wisc., 112 F.3d 869, 873 (7th Cir.1997).
cited Cited as authority (rule) Michael D. Brandt, on Behalf of Himself and All Others Similarly Situated v. Board of Education of City of Chicago
7th Cir. · 2007 · confidence medium
Co., 295 F.3d 677, 679-80 (7th Cir.2002); Morton v. Smith, 91 F.3d 867, 870 (7th Cir.1996).
cited Cited as authority (rule) Brandt, Michael D. v. Kotis, Chris
7th Cir. · 2007 · confidence medium
Co., 295 F.3d 677, 679-80 (7th Cir. 2002); Morton v. Smith, 91 F.3d 867, 870 (7th Cir. 1996).
cited Cited as authority (rule) Galvan v. SBC Pension Benefit Plan
5th Cir. · 2006 · confidence medium
Co. of Am., 295 F.3d 677, 678 (7th Cir.2002).
discussed Cited as authority (rule) Silva v. Fortis Benefits Insurance
N.D. Ill. · 2006 · confidence medium
Stark v. PPM America, Inc., 354 F.3d 666 , 671 (7th Cir.2004); Zhou v. Guardian Life Insurance Co. of America, 295 F.3d 677, 679 (7th Cir.2002); Doe v. Blue Cross & Blue Shield United of Wisconsin, 112 F.3d 869, 873 (7th Cir.1997).
cited Cited as authority (rule) Donaldson v. Pharmacia Pension Plan
S.D. Ill. · 2006 · confidence medium
Co. of Am., 295 F.3d 677, 679 (7th Cir.2002) (“[W]e review a district court’s decision to dismiss a complaint on exhaustion grounds for an abuse of discretion.”).
discussed Cited as authority (rule) Barix Clinics of Ohio, Inc. v. Longaberger Family of Companies Group Medical Plan
S.D. Ohio · 2005 · confidence medium
Co. of America, 295 F.3d 677, 680 (7th Cir.2002) (affirming dismissal where plaintiff proffered only “bald allegations and conclusory statements” in support of futility argument; “When a party has proffered no facts indicating that the review procedure that he initiated will not work, the futility exception does not apply.”); Byrd v. MacPapers, Inc., 961 F.2d 157, 160-61 (11th Cir.1992)(dismissal for failure to exhaust administrative remedies upheld where plaintiff failed to allege whether she pursued any available relief under claims procedures).
cited Cited as authority (rule) Andrew Ruttenberg v. United States Life Insurance Company in the City of New York, a Subsidiary of American General Corporation
7th Cir. · 2005 · confidence medium
Co. of America, 295 F.3d 677, 679 (7th Cir.2002).
cited Cited as authority (rule) Ruttenberg, Andrew v. US Life Insur NY
7th Cir. · 2005 · confidence medium
Co. of America, 295 F.3d 677, 679 (7th Cir. 2002).
cited Cited as authority (rule) Grenell v. UPS Health and Welfare Package
C.D. Cal. · 2005 · confidence medium
Co. of Am., 295 F.3d 677, 680 (7th Cir.2002) (“When a party has proffered no facts indicating that the review procedure that he initiated will not work, the futility exception does not apply.”).
cited Cited as authority (rule) Anderson v. Lasalle Steel Co.
7th Cir. · 2005 · confidence medium
Co. of Am., 295 F.3d 677, 679-80 (7th Cir.2002); Doe v. Blue Cross & Blue Shield United of Wis., 112 F.3d 869, 873 (7th Cir.1997); Filipowicz v. Am.
cited Cited as authority (rule) Old Republic Surety Company v. McGhee
Ark. · 2005 · confidence medium
Id. at 680 (citations omitted) (emphasis added).
discussed Cited as authority (rule) Jacobs v. Xerox Corporation Long Term Disability Income Plan
N.D. Ill. · 2005 · confidence medium
Co., 295 F.3d 677, 679 (7th Cir.2002) (explaining that the requirement of administrative exhaustion furthers the goals of “minimizing the number of frivolous lawsuits” and “enables the preparation of a more eom-píete factual record for judicial review,” and that a decision to require administrative exhaustion will not be reversed unless “downright unreasonable”) (internal quotations and citations omitted); Lindemann v. Mobil Oil Corp., 79 F.3d 647, 650 (7th Cir.1996) (explaining various reasons for requiring exhaustion).
cited Cited as authority (rule) Jones v. State Wide Aluminum, Inc.
N.D. Ind. · 2003 · confidence medium
Co. of America, 295 F.3d 677, 679 (7th Cir.2002) (referring to internal exhaustion as a prerequisite for filing suit under ERISA); Gallegos v. Mt.
Retrieving the full opinion text from the archive…
Jin ZHOU, Plaintiff-Appellant,
v.
GUARDIAN LIFE INSURANCE COMPANY OF AMERICA, Defendant-Appellee
02-1074.
Court of Appeals for the Seventh Circuit.
Aug 13, 2002.
295 F.3d 677
James P. Ginzkey (argued), Hayes, Hammer, Miles, Cox & Ginzkey, Bloom-ington, IL, for plaintiff-appellant., Randy J. Curato, Edward M. Graham (argued), Bell, Boyd & Lloyd, Chicago, IL, for defendant-appellee.
Flaum, Wood, Manion.
Cited by 43 opinions  |  Published
FLAUM, Chief Judge.

Jin Zhou, a licensed chiropractor, treated Arleen Baker from June to October of 2000. Baker participated in an insurance plan for which Guardian Life Insurance Co. of America (“Guardian”) administered the claims. Baker assigned Zhou the right to receive payment from Guardian. That is, rather than bill Baker directly, Baker permitted Zhou to submit the costs of his treatment directly to Guardian. When Guardian denied full payment of these claims, Zhou filed suit. The district court dismissed Zhou’s claims because he failed to exhaust his administrative remedies and, alternatively, because the rights Baker attempted to assign were unassignable. For the reasons stated below, we affirm the district court’s decision.

I. BACKGROUND

From June 13, 2000 to October 27, 2000, Zhou saw Baker in his office over thirty times. Baker assigned her reimbursement rights under her healthcare plan (“the Plan”) to Zhou, who submitted a bill to Guardian for the services he rendered during the above period. Guardian, in turn, forwarded Zhou’s record of treatments to an independent medical review consultant. The consultant determined that, after September 9, 2000, Baker required only one office visit for chiropractic treatment per week. On October 27, 2000, based upon this report, Guardian determined that the claims submitted by Zhou exceeded what was medically necessary and partially denied payment. However, Guardian invited Zhou to submit additional documentation and to request further review of its claim decision.

On December 19, 2000, after some correspondence and telephone contact between the parties, Zhou filed an appeal of Guardian’s partial denial of benefits. In this letter, Zhou claimed that the procedural notice afforded to him by Guardian was inadequate under the Employee Retire[*679] ment Income Security Act (“ERISA”) because, inter alia, “it fail[ed] to provide the specific reason or reasons for denial and the specific reference to pertinent documents on which the denial is based.” In addition, Zhou requested that Guardian provide him with Plan documents, the names of Guardian employees who reviewed his claim, as well as all internal Guardian communications pertaining to his file. On April 4, 2001, Zhou sent a second letter, reiterating his request for certain documents. Guardian acknowledged receipt of Zhou’s appeal and request for information on April 30, 2001. In its correspondence to Zhou, Guardian indicated that his appeal (and his requests for information) would be reviewed by Guardian’s legal department.

On June 6, 2001, Guardian issued its response to Zhou’s appeal and request, for information. In this response, Guardian stood by its partial denial of benefits— citing a report from a second medical consultant who confirmed that the number of treatments given by Zhou to Baker exceeded medical necessity. With respect to Zhou’s requests for information, Guardian told him that it was not the Plan sponsor, or Plan fiduciary. Rather, Guardian identified itself as a fiduciary only with respect to the processing and payment of claims. According to Guardian, Zhou was required to seek the governing Plan documents from the actual Plan sponsor. In addition, Guardian flatly refused to identify the individuals who participated in the review and partial denial of Zhou’s claim or to release any internal Guardian communications. Lastly, Guardian invited Zhou to pursue a further appeal of its decisions.

Zhou declined to pursue further administrative appeals and instead, on June 25, 2001, filed suit. In his complaint, Zhou alleged two separate theories of recovery under ERISA. First, Zhou sought to recover payment of benefits. Next, Zhou claimed that, in failing to release Plan documents, Guardian violated ERISA’s disclosure and reporting requirements.

Guardian moved to dismiss Zhou’s complaint on two principal grounds: that he failed to exhaust his administrative remedies by pursuing further appeals and that, as a third-party assignee of benefits, he lacked standing to bring suit. The district court granted Guardian’s motion, stating that Zhou’s complaint merited dismissal on both grounds.

This appeal has ensued.

II. DISCUSSION

At the outset, we need not reach the issue of whether Zhou lacks standing to bring suit under the Plan as a third-party assignee of benefits. Instead, this case may be resolved solely on exhaustion grounds.

As a pre-requisite to filing suit, an ERISA plaintiff must exhaust his internal administrative remedies. Doe v. Blue Cross & Blue Shield United of Wisc., 112 F.3d 869, 873 (7th Cir.1997). This requirement furthers the “goals of minimizing the number of frivolous lawsuits” and enables the preparation of a more complete factual record for judicial review. Gallegos v. Mt. Sinai Medical Center, 210 F.3d 803, 807-08 (7th Cir.2000). Accordingly, we review a district court’s decision to dismiss a complaint on exhaustion grounds for an abuse of discretion. See, e.g., Shawnee Trail Conservancy v. U.S. Dept. of Agriculture, 222 F.3d 383, 389 (7th Cir.2000). A party appealing under this standard bears a heavy burden, for “a decision constitutes an abuse of discretion when it is not just clearly incorrect, but down-right unreasonable.” Cincinnati Ins. Co. v. Flanders Elec. Motor Svc., 131 F.3d 625, 628 (7th Cir.1997). We find that the district court[*680] did not abuse its discretion in dismissing Zhou’s complaint.

Zhou admits that he did not exhaust his administrative remedies and pursue further administrative appeals of the partial denial of his claim. Perhaps in an effort to cure this defect, Zhou now claims that he was excused from exhaustion by the alleged futility of further appeal. There is indeed an exception to the exhaustion requirement when further administrative appeal is futile. See Lindemann v. Mobil Oil Corp., 79 F.3d 647, 650 (7th Cir.1996). However, for a party to come within the futility exception, he “must show that it is certain that [his] claim will be denied on appeal, not merely that he doubts that an appeal will result in a different decision.” Id. Save for bald allegations and conclusory statements, Zhou has proffered no facts that would lead this court to find that it was a certainty that further administrative appeal would result in a denial of his claim. When a party has proffered no facts indicating that the review procedure that he initiated will not work, the futility exception does not apply. See, e.g., Talamine v. Unum Life Ins. Co. of America, 803 F.Supp. 198, 201 (N.D.Ill.1992).

In light of Zhou’s failure to support his assertions that further administrative appeal would have been futile, and the deferential standard of review that we must exercise, the district court’s opinion is AfFIRMED.