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Insurance Labor & Employment Civil Procedure

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A Seemingly Important Win for Wisconsin Worker’s Compensation Insurance Carriers and Employers

by Ruder Ware on

On its face the decision of the Wisconsin Supreme Court in Flug v. LIRC, 2017 WI 72 (decided on June 30, 2017), is a clear, important win for the employer side in common injuries that involve pre-existing degenerative...more

Massachusetts High Court: Insurers Not Obligated to Prosecute Counterclaims under Duty-to-Defend Policies

by Wilson Elser on

On June 22, 2017, the Massachusetts Supreme Judicial Court (SJC) in Mount Vernon Fire Insurance Co. v. Visionaid, Inc. (No. SJC-12142) considered three questions certified by the First Circuit Court of Appeals addressing the...more

Massachusetts Supreme Court Ruling will Lead to More Disappointments for Employers who Purchase EPLI Policies

by Partridge Snow & Hahn LLP on

Are you sleeping better knowing that you have purchased Employment Practices Liability Insurance (“EPLI”) to cover your company against employment claims? Well it may be time to wake up....more

Fifth Circuit Reverses Mississippi District Court’s Interpretation of “Ambiguous” Language to Nullify Defense Within Limits...

by Carlton Fields on

Insurance policies that include the cost of defending a particular claim or action within the policy’s limit of liability, often referred to as “burning,” “eroding,” or “defense within” limits policies, are common in the...more

Second Circuit Affirms the Dismissal of a SOX Claim for Failing to Meet the “Reasonable Belief” Standard

On June 1, 2017, the Second Circuit affirmed the dismissal of a Sarbanes-Oxley Act (“SOX”) whistleblower retaliation claim brought by a former Metropolitan Life Insurance Co. (“Company”) employee because the employee lacked a...more

Fifth Circuit’s Pierre Deference In ERISA Cases Trumps Texas’s Anti-Discretionary Language Statute

by DeWitt Law, LLC on

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174, 2017 U.S. App. LEXIS 7072(5th Cir. Apr. 21, 2017), which involved a claim for benefits under an ERISA-governed health policy, the Fifth Circuit held that...more

Court Vacates Arbitration Award For Arbitrator’s Evident Partiality

by Carlton Fields on

A New York Court vacated an arbitration award, finding that a party appointed arbitrator’s undisclosed relationships with the appointing party amounted to a relatively infrequent instance in which such nondisclosure...more

Back to Basics – Costly Consequences of Ignoring Process in Benefits Administration

The stories of an employer and a long-term disability insurer and claims fiduciary for an ERISA plan, defendants in two recent cases, ring so true. In the first case, the insurer was designated as claims fiduciary for an...more

Grounding Deferential Review in California – No Preemption for Discretionary Clause Ban

by Seyfarth Shaw LLP on

Seyfarth Synopsis: In a decision with wide ranging implications, the Ninth Circuit has ruled that a discretionary clause in an employer drafted plan document is subject to, and invalidated by, California’s insurance...more

April 2017 Independent Contractor Misclassification and Compliance News Update

by Pepper Hamilton LLP on

April was a red-hot month for independent contractor misclassification cases. We report below on 11 cases in the courts and two before administrative agencies involving...more

New Class Action Lawsuits Asserting Violations of the MHPAEA

Banner Health and the Kaiser Foundation were recently hit with separate class action lawsuits challenging their denials of certain mental health care coverage...more

HR 1313 and the Future of Employee Wellness Programs

by Fisher Phillips on

On March 8, the House’s Education and Workforce Committee passed a bill, HR 1313 – Preserving Employee Wellness Programs Act. The bill, which was introduced by U.S. Rep. Virginia Foxx in order to “reaffirm existing law to...more

Fifth Circuit: Discretionary Ban Does Not Mandate De Novo Review

by Seyfarth Shaw LLP on

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174 (5th Cir. Apr. 21, 2017), the Firth Circuit concluded that Texas’ ban on discretionary clauses in certain insurance policies did not require a de novo review of...more

Putative Class Action Involving A Patented Reinsurance Arrangement For Workers’ Compensation Coverage Largely Survives Dismissal

by Carlton Fields on

The case is pending in a federal district court in New York, and involves three allegedly interconnected contracts purportedly “designed to circumvent [state] insurance laws,” including the laws of New York. ...more

Unemployment Benefits Do Not Factor Into Damages Calculations in Employment Discrimination Lawsuits

A recent New Jersey Appellate Division opinion now makes it explicitly clear that unemployment benefits cannot be deducted from back pay damages in employment discrimination cases under the New Jersey Law Against...more

Supreme Court Decides Coventry Health Care of Missouri, Inc. v. Nevils

by Faegre Baker Daniels on

On April 18, 2017, the Supreme Court of the United States decided Coventry Health Care of Missouri, Inc. v. Nevils, No. 16-149, holding that: 1) under the FEHBA (specifically, 5 U.S.C. § 8902(m)(1)), the provisions of a...more

An Owner May Lend a Vehicle with a Valid Prohibition Against Lending It to a Third Party

by Field Law on

If you loan your vehicle to someone, can you impose a condition that they not lend it on to an unknown third party? In the decade since Mugford v. Weber, the law has been that owners cannot put conditions on their consent to...more

Pennsylvania Appellate Court Denies Petition To Transfer Structured Settlement Involving LHWCA

by Carlton Fields on

Relying on Federal Court precedent, a Pennsylvania intermediate appellate court resolved whether the plain language of Section 916 of the Longshore and Harbor Workers’ Compensation Act (“LHWCA”) prohibits the assignment of...more

Connecticut Supreme Court Issues Important Clarification For Independent Contractor Test

On March 21, 2017, the Connecticut Supreme Court issued an important ruling, finding that an individual may be still considered an independent contractor under the state’s Unemployment Insurance Act even if he/she only...more

Wisconsin Unemployment Insurance Benefits Upon Discharge for Absenteeism – the Employer’s Policy May Be More Generous, But Not...

by Ruder Ware on

The Wisconsin Court of Appeals issued a decision in an unemployment insurance benefits case on March 8 that provides clarity where an employee is discharged for absenteeism. The case is Wisconsin Department of Workforce...more

Labor Department Boosts Disability Claimant Protections

by Fisher Phillips on

The U.S. Department of Labor (USDOL) recently issued a final rule addressing disability benefit claims and appeals (see 81 FR 92316). The rule adds new procedural protections and safeguards meant to ensure disability...more

California Supreme Court Upholds Public Retirement Boards' Fiduciary Role When Adjudicating Disability Retirement Applications

by Nossaman LLP on

In a victory for the San Bernardino County Employees’ Retirement Association (“SBCERA”) and the nineteen other county retirement systems administered under the County Employees Retirement Law of 1937 (Gov. Code, § 31450 et...more

ERISA: 7 Things to Know About Limited Discovery in ERISA Long Term Disability Cases

You already know that discovery in ERISA cases is generally limited because of the “significant ERISA policy interests of minimizing costs of claim disputes and ensuring prompt claims-resolution procedures.”...more

Illinois Supreme Court Holds Occupational Disease Pension Does Not Trigger Health Insurance Benefits

by Sedgwick LLP on

In 2003, the Illinois Supreme Court held that anyone who qualified for a line-of-duty pension under section 4-110 of the Illinois Pension Code qualified as having a “catastrophic injury” within the meaning of Section 10(a) of...more

Indiana Applies Heightened Summary Judgment Standard In Determining Vicarious Liability For An Employee Driving A Provided Company...

by Reminger Co., LPA on

For an employee, the opportunity to drive a company vehicle is certainly a job perk. For an employer, however, issuing company vehicles comes with the risk that it may be held liable for any negligence of the employee arising...more

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