Civil Remedies, Labor & Employment Law, Insurance

ERISA Litigation Alert: Check Your Plan Subrogation and Reimbursement Language to Eliminate “Contractual Gaps”

by Richard Birmingham | Davis Wright Tremaine LLP on 5/21/2013

In U.S. Airways v. McCutchen, the U.S. Supreme Court upheld the ability of U.S. Airways’ health plan to recover medical expenses that it previously paid to the injured party from a third party settlement, but remanded the...more

Monthly Benefits Update - April 2013

by Andrew Malahowski | Franczek Radelet P.C. on 5/1/2013

Health Care Reform: Guidance on Required Future Modifications to SBC, Other Issues - The Internal Revenue Service (IRS), Department of Labor (DOL), and Department of Health and Human Services (HHS) issued new guidance...more

New Whistleblower Bounty Law On The Horizon In NY?

by Steven J. Pearlman, Daniel Saperstein | Proskauer - Whistleblowing & Retaliation on 5/1/2013

On March 22, 2013, the New York State Senate introduced the S4362 Proposal which, through a “bounty,” gives financial awards to whistleblowers who provide original information to the Department of Financial Services (DFS)...more

ERISA Legal News - 1st Quarter, 2013 • Volume 4, Number 1

by Kimberly Ruppel | Dickinson Wright on 4/23/2013

In This Issue: - Supreme Court Update: Where Plan Reimbursement Or Recovery Terms Are Ambiguous Or Silent,Equitable Doctrines May Fill The Gaps: US Airways, Inc. v. McCutchen, 569 U.S. ___ (2013). In an...more

Supreme Court Upholds Health Plan’s Right To Recover Money from Third Party

by Edward I. Leeds | Ballard Spahr LLP on 4/23/2013

The U.S. Supreme Court has ruled that the clear terms of an employer's group health plan override an employee's equitable defenses in determining the plan's right to recover amounts from a third party. This decision points...more

Multiple Employer Welfare Arrangements: New Reporting Requirements, Civil Penalties and Other Regulations

by Steven Sebastian, Leigh Ann Wilson | BakerHostetler on 4/19/2013

Generally, a multiple employer welfare arrangement (MEWA) is a welfare benefit program that is sponsored by a group of employers that have common business and industry interests, but not common ownership interests. The...more

Supreme Court “Dooms” Equitable Defenses to Plan’s Reimbursement Provisions

by Lori Oliphant | Winstead PC on 4/19/2013

In a prior blog, I discussed the importance of including unambiguous reimbursement rights in health plan documents in order to manage healthcare costs. The enforceability of such rights was confirmed by the United States...more

High Court Rules Equitable Defenses Don’t Override ERISA Plan Terms

by Ogletree, Deakins, Nash, Smoak & Stewart,... on 4/19/2013

On April 16, 2013, the U.S. Supreme Court issued its decision in US Airways, Inc. v. McCutchen (No. 11–1285), deciding the issue of whether equitable defenses, such as the principle of unjust enrichment, can override the...more

U.S. Supreme Court: Equity Cannot Trump ERISA Plan Terms in ERISA Reimbursement Case

by D. Michael Reilly | Lane Powell PC - ERISA Law on 4/18/2013

The U.S. Supreme Court yesterday strengthened the ability of employer health insurance plans to recoup payments for medical expenses paid for an injured plan participant who later sues to recover damages from a third...more

The U.S. Supreme Court Upholds Plan Sponsor’s Recovery Of Participant Damages Award

by Jeffrey P. Cairns | Leonard, Street and Deinard - Employee... on 4/18/2013

On April 16, 2013, the U.S. Supreme Court issued its opinion in U.S. Airways, Inc. v. McCutchen finding in favor of U.S. Airways in its quest to recover $66,866 in medical expenses incurred by its employee as a result of a...more

Saskatchewan Trial Court Awards Record Punitive Damages for Insurer Bad Faith

by Michael Doerksen | Field Law on 4/15/2013

A Justice of the Saskatchewan Court of Queen’s Bench has assessed punitive damages totalling $4,500,000 against two insurers in a recent trial decision, Branco v. American Home Assurance et. al., 2013 SKQB 98. In rendering a...more

Religious Institutions Update: April 2013

by Nathan A. Adams IV | Holland & Knight LLP on 4/8/2013

Implementation of the Patient Protection and Affordable Care Act (PPACA) is in full swing. The law requires non-exempt religious organizations with fewer than 50 full-time employees to determine whether they are a large...more

Subrogation Claims are “Equitable Relief” Governed by ERISA

by D. Michael Reilly | Lane Powell PC - ERISA Law on 3/26/2013

That subrogation claim you have might be governed by ERISA, at least in some circuits… Here’s the case of Thurber v. Aetna Life Insurance Company, __F.3d__ (2nd Cir. March 13, 2013) (Insurer’s counterclaim for return...more

Claims Administrator Does Not Have to Pay Statutory Penalties for Failing to Provide Requested Documents

by D. Michael Reilly | Lane Powell PC - ERISA Law on 3/26/2013

You know already that a plan administrator can be liable for statutory penalties under ERISA for failing to provide requested plan documents....more

Second Circuit Holds That Insurers May Recover Overpayments of Benefits Under ERISA

by Julie Kim | Sedgwick LLP on 3/20/2013

On March 13, the Second Circuit issued a significant opinion interpreting key provisions of the Employee Retirement Income Security Act (“ERISA”). In Thurber v. Aetna Life Ins. Co., Case No. 12-370-cv, 2013 WL 950704 (2d...more

ERISA Does Not Preempt State Court Order Requiring Beneficiary to Renounce Right to Employee’s Plan Benefits, Fourth Circuit Rules

by Katherine Lange | Womble Carlyle Sandridge & Rice, PLLC on 3/20/2013

The scenario is not difficult to imagine: An employee designates her spouse as the primary beneficiary under her employer’s life insurance and retirement benefit plans. Years later, the couple divorces, and in the marital...more

Court Rules That Ohio Bureau Of Workers' Compensation Overcharged Non-Group Rated Employers

by Fisher & Phillips LLP on 1/10/2013

After a long bench trial which began on August 20, 2012, Judge Richard McMonagle recently issued his decision in an important class-action lawsuit. The suit was brought on behalf of certain employers doing business in Ohio,...more

Pay me once, pay me twice, pay me thrice?

by Glen A. Murphy | Spilman Thomas & Battle, PLLC on 12/12/2012

On November 15th the Supreme Court of Appeals of West Virginia issued the opinion of Jeffery Jenkins, et ux. v. City of Elkins, et al. (No. 11-1059). Factually, Mr. Jenkins was an employee of Bombardier Aerospace driving a...more

Healthcare Law Newsletter Fall/Winter 2012 - Seventh Circuit Curtails the Scope of Injunctive Relief Available

by John T. Seybert | Sedgwick LLP on 12/11/2012

The Employee Retirement Income Security Act of 1974 Section §502(a)(3), 29 U.S.C. §1132(a)(3) (ERISA) allows a fiduciary to seek an order in federal court “to enjoin any act or practice which violates any provision of this...more

Company Demands Cost of Medical Bills from Injured Employee

by Michele Bowman | Lawyers.com on 11/29/2012

The U.S. Supreme Court heard arguments this week in a case that could change workers’ ability to hire lawyers to help them bring personal injury suits when their employers have paid for their medical expenses....more

Who Cares if I Give a COBRA Notice for My Dental Plan?

by Leonard, Street and Deinard - Employee... on 11/28/2012

Employers are generally aware that medical plans are subject to continuation coverage under the federal law known as COBRA. They may forget that COBRA extends to all group health plans, including dental, vision and medical...more

Affordable Care Act Runs Into Religious Freedom Issues in Court

by Franczek Radelet P.C. on 8/16/2012

Although the Supreme Court, in a landmark decision earlier this summer, affirmed the constitutionality of the Patient Protection and Affordable Care Act (ACA), the challenges to and controversies surrounding that Act are far...more

Administrative Exemption To Overtime Compensation Requirements Did Not Apply To Insurance Claims Adjusters

by Kronick, Moskovitz, Tiedemann & Girard on 8/1/2012

A court of appeal recently rejected two insurance companies’ assertion that the administrative exemption to the overtime compensation requirements applied to their insurance claims adjusters in the adjusters’ lawsuit seeking...more

General Liability Insurance After The EL Trigger Litigation -- What Is The Current State of Policy Attachment in Injury Cases?

by Sedgwick LLP on 7/18/2012

On 28 March 2012, the UK Supreme Court handed down its eagerly anticipated judgment in Durham v BAI, otherwise known as the “EL Trigger Litigation”. Much has already been written about the decision itself. In this bulletin we...more

Massachusetts Court Holds No Coverage for Withheld Employee Tips

by Traub Lieberman Straus & Shrewsberry LLP on 7/10/2012

In its recent decision in Berkshire-Cranwell Limited Partnership v. Tokio Marine & Nichido Fire Ins. Co., 2012 U.S. Dist. LEXIS 93635 (D. Mass. July 6, 2012), the United States District Court for the District of Massachusetts...more

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Civil Remedies › Labor & Employment Law › Insurance