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Tenth Circuit Addresses ERISA Limitations Provision in Class Action Decision

In Fulghum v. Embarq. Corp., 785 F.3d 395 (10th Cir. 2015), the Tenth Circuit Court of Appeals considered the claims of a class of telephone company retirees whose life and health insurance benefits were reduced or eliminated...more

Washington Federal Court Decertifies Class of Insurance Agents Alleging Entitlement to Overtime

Challenging the classification of workers as independent contractors continues to be a growing area of focus for plaintiffs’ attorneys. However, as a recent federal case from Washington demonstrates, the fact-intensive...more

Agents Can’t Insure Class Treatment – Varied Experiences Require Decertification

Last week, a federal district court decertified a Rule 23 class of more than 1,000 insurance agents who claimed that Bankers Life and Casualty Co. misclassified them as independent contractors, and, as a result, they were...more

In the Wake of Heimeshoff, the 11th Circuit and Equitable Tolling of Reasonable Contractual Time Limitations

As all ERISA practitioners are now well aware, in Heimeshoff v. Hartford Life & Accident Ins Co., 134 S.Ct. 604 (2013), the United States Supreme Court provided that contractual time limitations provisions are enforceable in...more

Bank Bond Covers Third-Party Losses Arising out of Bank Employee’s Fraud, Eighth Circuit Holds

Fidelity bonds are purchased primarily to protect against loss to the policyholder’s own assets, from things like employee theft or embezzlement. In Avon State Bank v. BancInsure, Inc., however, the Eighth Circuit interpreted...more

Apples From Applesauce? Implications of the Supreme Court's Ruling on Obamacare

Can you make apples out of applesauce? A first look at implications of the United States Supreme Court's decision (once again) in favor of the Affordable Care Act....more

King v. Burwell: The Supreme Court Rules in Favor of the Administration and the Affordable Care Act Survives

The U.S. Supreme Court has once again ruled in favor of the Affordable Care Act (ACA). At issue in King. v. Burwell was whether the landmark legislation allows federal subsidies to be given to low-income consumers residing...more

What does "will be insured" actually mean?

Balancing obligations to provide health and life insurance benefits to retirees with other legitimate business needs can be tricky. Although retirees depend on the benefits, employers may need to modify benefit plans for...more

Sixth Circuit Holds No Disgorgement of Profits Based on Wrongfully Denied ERISA Disability Benefits

The Sixth Circuit Court of Appeals, sitting en banc, recently decided a closely-watched case regarding the scope of "other appropriate equitable relief" under ERISA Section 502(a)(3). In Rochow v. LINA, the court held that...more

ERISA Preemption Trumps State Insurance Law Yet Again: Ninth Circuit Declines to Apply California’s Insurance Notice-Prejudice...

In a recent decision, the Ninth Circuit Court of Appeals rejected a Plan participant’s attempt to extend California insurance law’s notice-prejudice rule to self-insured ERISA plans. Zagon v. Am. Airlines, Inc., 2015 BL...more

Virginia Federal Court Sustains Late Notice Disclaimer

In its recent decision in E Dillon & Co. v. Travelers Cas. & Sur. Co. of America, 2015 U.S. Dist. LEXIS 76295 (W.D. Va. June 12, 2015), the United States District Court for the Western District of Virginia, applying Virginia...more

Pennsylvania Supreme Court gets a little help from its friends

The Pennsylvania Supreme Court clarified an important liability insurance issue the other day. Mut. Benefit Ins. Co. v. Politsopoulos, 2015 Pa. LEXIS 1126 (Pa. May 26, 2015) (exclusion for liability for injury to “[a]n...more

ERISA 11th Circuit: Claimant Has “Duty to Investigate” When Asserting Equitable Tolling of a Contractual Limitations Provision

You already know that contractual limitations provisions in ERISA plans are generally enforceable and can bar untimely claims. But when does the court apply “equitable tolling” to extend the time by which a claimant may...more

King v. Burwell – Will the Supreme Court Tip the ACA Dominos? Part 1

The health care industry has been closely watching four cases challenging whether federal subsidies could be used to reduce costs to consumers for health insurance purchased on an Affordable Care Act (ACA) Exchange in a state...more

Ninth Circuit Extends ERISA Deadline, Revives Untimely Appeal

Last week, the Ninth Circuit Court of Appeals issued its opinion in LeGras v. AETNA Life Insurance Company, No. 12-56541 (May 28, 2015), holding that the 180-day period to appeal a denial of a long-term disability claim was...more

ERISA (9th Cir.) A Day Late, But Not A Dollar Short — Counting The 180 Day Appeal Period Gets Easier For Claimants

You know that under ERISA regulations a claimant has at least 180 days to appeal a benefit denial. ERISA plans set out contractual timelines for appeals. But what happens when that 180 day period runs out on a weekend?...more

"The" insured versus "any" insured: The Pennsylvania Supreme Court limits the application of the employer’s liability exclusion

Drawing heavily from an amicus brief authored by Reed Smith Insurance Recovery Group (“IRG”) attorneys in Pittsburgh, the Pennsylvania Supreme Court just issued a pivotal decision that effectively shuts down an avenue that...more

Pennsylvania Court Holds Disputed Allegations In Complaint Do Not Negate Duty to Defend

In its recent decision in Navigators Ins. Co. v. Amsterdam, 2015 U.S. Dist. LEXIS 64385 (E.D. Pa. May 18, 2015), the United States District Court for the Eastern District of Pennsylvania had occasion to consider whether an...more

RMF Litigators Obtain Reversal Of Denial Of Long-Term Disability Benefits

When a private insurance company denies a claim for long-term disability benefits, one appeals that decision through that same insurance company’s appeal process. This does not bode particularly well for the appealing...more

Insurance Recovery Law - May 2015

California Appellate Court: All Claims “Arising From” Ponzi Scheme Are Precluded - Why it matters: Concluding that any claims related to a Ponzi scheme—even if they involved different investors, investments, or...more

Federal Court Changes the Playing Field on ‘Agreed’ Civil Penalties in Regulatory Proceedings

The very recent decision of the Full Court of the Federal Court (handed down on 1 May 2015) in Director, Fair Work Building Industry Inspectorate v CFMEU [2015] FCAFC 59 has changed the law in relation to the Court’s approach...more

En Banc Mississippi Court of Appeals Affirms Summary Judgment for Insurer, Adjuster and Employer on Bad Faith Claims Arising from...

Chapman v. Coca-Cola Bottling Co., No. 2013-CA-01883-COA (Miss. Ct. App. Mar. 17, 2015). Ruling en banc, court affirms grant of summary judgment for insurer, adjuster and employer on bad faith claims brought by former...more

ERISA: Public School Teacher’s Employee Benefits Governed by ERISA? Yes!

When you see a claim for disability or life insurance benefits by a public school teacher, you might assume the claim is not governed by ERISA because of the governmental plan exception....more

All “Intentional Tort” Claims By Employees May Now Be Uninsurable

On March 12, 2015, the Supreme Court of Ohio issued a decision in Hoyle v. DTJ Enterprises, Inc., holding that an insurance provision that excludes coverage for acts committed with the “deliberate intent to injure an...more

Bad Faith Sentinel - April 2015

In This Issue: - En Banc Mississippi Court of Appeals Affirms Summary Judgment for Insurer, Adjuster and Employer on Bad Faith Claims Arising from Denial of Coverage and Benefits for Work-Related Injury -...more

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