Monetary Damages Potentially Available For Inadequate Disclosure

In Weaver Bros. Ins. Assoc., Inc. v. Braunstein, No. 11-5407, 2013 WL 1195529 (E.D. Pa. Mar. 25, 2013), a district court denied the plan administrator’s motion for judgment on the pleadings, ruling that monetary relief may be available for ERISA violations associated with the plan administrator’s failure to properly communicate the participant’s benefit rights following conversion from full-time employment to disabled status. The participant, Ms. Braunstein, was covered by a life insurance policy through her employer, but coverage lapsed 12 months after she left “active” employment for disability leave. The court first determined that the plan administrator failed to provide an adequate summary plan description and that this precluded Ms. Braunstein from independently learning of her right to convert to an individual policy. The court also determined that since the plan administrator had actual knowledge of Ms. Braunstein’s prolonged illness, it had an affirmative duty to inform her of “material information that could affect [her] benefits” – such as the policy conversion clause. Finally, relying on CIGNA Corp v. Amara, 131 S. Ct. 1866 (2011), the court rejected the plan administrator’s argument that damages were limited to non-monetary “equitable” relief, and that under these circumstances, the participant’s estate may be entitled to recover the face value of the participant’s life insurance policy as a “surcharge” remedy.

Topics:  Damages, Disability, Disclosure Requirements, ERISA, Inadequate Warning, Life Insurance, Plan Administrators

Published In: Business Torts Updates, Civil Procedure Updates, Civil Remedies Updates, Labor & Employment Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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