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Wisconsin Supreme Court Accepts New Cases: Occurrences, 12% Interest, and Donning and Doffing

Last Friday, Wisconsin’s supreme court announced that it had accepted seven new cases. Three of them are of particular interest to Wisconsin businesses. In Wis. Pharmacal Co. v. Nebraska Cultures of Cal.,...more

Is an Underinsured Motorist Policy Subject to the Automatic Bankruptcy Stay?

Imagine: an employee is injured in a car accident with another driver who is at fault. The employee settles with the at-fault driver for the limits of her liability policy. The employee, whose injuries exceed the at-fault...more

Summary of California Appellate Decisions - March 2015

HOW TO USE THIS CASE SERVICE - When you receive your summaries, each page will have an alphabetical letter located in the upper right-hand corner. Each alphabetical letter corresponds to a separate subject matter...more

En Banc Sixth Circuit Rules Against Disgorgement Remedy in Benefits Case

In Rochow v. Life Insurance Company of North America, No. 12-2074 (6th Cir. March 5, 2015), the U.S. Court of Appeals for the Sixth Circuit, sitting en banc, ruled that an insurance company that wrongfully denied benefits to...more

Disgorgement of Profits Not Available for Arbitrary and Capricious Benefits Denial – This Time

Wrongful denial of employee benefits will not expose plan fiduciaries to equitable remedies – such as disgorgement of profits – where restoration of benefits is adequate to make the claimant whole, says the Sixth Circuit in...more

ERISA: 6th Circuit — Plop Plop, Fizz Fizz: Oh What A RELIEF It Is: No Disgorgement For Arbitrary Denial Of Benefits

Does an arbitrary and capricious denial of ERISA governed disability benefits create a right to disgorgement of profits? NO....more

Revisiting Rochow: The Sixth Circuit Rejects Earlier $3.8 Million Equitable Award in Recent En Banc Decision

Just over a year ago, a panel decision by the Sixth Circuit Court of Appeals in Rochow v. Life Insurance Company of North America, 737 F.3d 415 made big news when the court upheld the district court’s award of $3.8 million in...more

Sixth Circuit Overturns the Lower Court’s Award of $3.8 Million in Alleged Profits Arising From a Denial of Benefits

The U. S. Court of Appeals for the Sixth Circuit, sitting en banc, has overturned the decision of a divided three-judge Sixth Circuit panel which had affirmed the district court’s award of $3.8 million of “disgorged” profits,...more

District Court Defines Surcharge Broadly

A New York district court held that surcharge could include not only make-whole relief, but also consequential, exemplary, or punitive damages in limited circumstances where malice or fraud is involved. Plaintiff Janet...more

ERISA Fiduciaries Have a Duty to Inform

SUMMARY: In this case, the court found that the employer, serving as plan administrator of a group life insurance plan providing basic and supplemental coverage, may be liable for monetary damages for breach of its fiduciary...more

ERISA: Plaintiff’s Attorney Fees Denied — Filing Of Lawsuit Was Not Reason Why Benefits Were Granted

You already know that in ERISA cases a court may, in its discretion, award attorney fees if a party achieved “some degree of success on the merits.”...more

Equitable Surcharge Awarded to Life Insurance Plan Beneficiary

A federal district court in California awarded relief in the form of surcharge to a life insurance plan beneficiary who claimed that a plan administrator failed to provide complete and accurate information in response to...more

Ask And You Shall Receive! Employers Should Interpret Requests For Plan Documents Broadly

The Sixth Circuit Court of Appeals recently joined a number of other appellate courts in adopting the “clear notice” standard under which a written request for copies of benefit plan documents subject to the Employee...more

Court Holds That ERISA Plaintiff Cannot Claim Equitable Remedies When the Plaintiff Has Adequate Remedies to Recover Plan...

A federal court has ruled that, although a recent U. S. Supreme Court decision expanded the kinds of equitable remedies available to a plaintiff under ERISA § 502(a)(3), those remedies are still unavailable when the ERISA...more

With Tax Season Looming, Appellate Division Refuses to Find Duty to Defend Against IRS Action

In William B. Kessler Memorial Hosp., Inc. v. North River Ins. Co., 2013 WL 6036678 (N.J. Super. Nov. 15, 2013), the Superior Court of New Jersey, Appellate Division, rejected the notion that an insurer’s promise to “defend...more

Sixth Circuit Issues Shocking Opinion Against ERISA Insurer, Dramatically Changes The ERISA Landscape

In what can only be described as a shocking opinion, the Sixth Circuit Court of Appeals issued a 2-1 decision affirming a lower court's award of $3.8 million dollars in disgorged profits to a former president of Arthur J....more

Sixth Circuit Expands Availability of Remedies Under ERISA

The Sixth Circuit recently concluded that a disability plan participant was entitled to relief consisting of benefits under the plan and disgorgement of defendant’s profits for delaying payment. In so ruling, the Court found...more

The Supreme Court Defers to Plan Language in U.S. Airways, Inc. v. McCutchen

Summary - In U.S. Airways, Inc. v. McCutchen, the US Supreme Court recently considered whether certain equitable defenses override the terms of a welfare plan in a plan fiduciary's suit for reimbursement under §...more

A Costly Change: Violation Of a Non-Solicitation Clause Results In a Multi-Million Dollar Award

A recent ruling entered in Pennsylvania state court is a stark reminder to employers and employees about the dangers associated with violating post-employment restrictive covenants such as non-compete and non-solicitation...more

Insurance Recovery Law -- Jul 11, 2013

A little knowledge can go a long way - The cases analyzed in this week's newsletter illustrate an important principle for policyholders: a basic understanding of how their policies work and the controlling insurance...more

7th Circuit Rules Employee May Recover Monetary Damages In ERISA Claim For Unpaid Benefits Against Insurer Who Denied Coverage...

The Seventh Circuit’s recent decision in Kenseth v. Dean Health Plan, Inc. provides a means for employees to collect monetary relief on their claim for benefits if they can show that the terms of the plan were not clear, and...more

Health Insurance Carriers Must Also Be Careful In What They Tell Plan Participants

I blogged recently warning employers to be careful when enrolling employees in plan benefits because the employer could be responsible to pay life insurance or disability benefits if an employee who is improperly enrolled...more

Express Plan Terms Allow Self-Insured Plan to Recover Medical Benefits Paid to Employee Post-McCutchen

In Quest Diagnostics v. Bomani, et al., 11-CV-00951 (D. Conn., June 19, 2013), the court granted Quest Diagnostic’s (“Quest”) motion for summary judgment, ruling that Quest, as the fiduciary to its self-insured medical plan,...more

Be Careful With Your Life Insurance Enrollments

Over the years there have been a number of cases that have involved employers improperly enrolling employees in group life or disability insurance benefits....more

Seventh Circuit Makes Damages More Available for Employees Given Wrong Information About Benefits

Kenseth v. Dean Health Plan, Inc., represents a significant departure from the decades of law prior to Cigna v. Amara holding that employees could not recover for misrepresentations by employers over benefit coverage if the...more

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