Lane Powell PC - ERISA Law Blog

ERISA: How Do You Spell (Equitable) Relief?

In an ERISA case, what does it take to assert a claim for equitable relief? If the complaint does not assert an alleged breach of fiduciary duty, the claim for equitable relief should be dismissed… Here’s the case of Owens…more
| Civil Procedure, Labor & Employment Law

ERISA: Court Establishes New Incentive to Bring Early Motions to Dismiss “Breach of Fiduciary Duty” Claims

You know that in ERISA cases most courts typically will limit review to the administrative record, absent special circumstances. Courts may also allow limited discovery when assessing whether a “conflict of interest” affected…more
| Civil Procedure, Labor & Employment Law

ERISA Preempts State Law Requiring Insurer “Prompt Payment”

Alaska’s prompt pay statute—which requires insurers to pay benefit claims within 30 days of submission—is preempted by federal laws governing employer-provided benefits and benefits for government workers, a federal judge ruled…more
| Civil Procedure, Conflict of Laws, Health, Insurance, Labor & Employment Law

ERISA: “Key Evidence Needed to Prove the Intoxication Exclusion”

You know that many insurance policies and ERISA-governed plans exclude from coverage disabilities “resulting from, or related to…any accident related to the voluntary influence of any drug, narcotic, intoxicant or chemical….”…more
| Civil Procedure, Insurance, Labor & Employment Law

DOL Increases Penalties on ERISA Plans – August 2, 2016

The Department of Labor (“DOL”) just increased civil monetary penalty amounts that may be assessed for violations of Title I of the Employee Retirement Income Security Act of 1974 (ERISA)…more
| Labor & Employment Law, Securities Law

ERISA — 7th Circuit: Under De Novo Review, the Court “Should NOT Resolve[] Doubts or Gaps in the Evidence in [the Claimant’s] Favor”

You know that claimants have the burden to establish eligibility for ERISA-governed disability benefits. Sometimes gaps in coverage can occur when, for example, a claimant alleges disability while using accrued vacation…more
| Civil Procedure, Insurance, Labor & Employment Law

ERISA: 2nd Circuit — Mental Health Provider Lacks Standing to Challenge ERISA Benefit Denial

Who can challenge an ERISA benefit denial? Does a physician have standing to challenge the denial of a patient’s coverage? It depends…more
| Civil Procedure, Health, Insurance, Labor & Employment Law

ERISA: Is It Wrong to Take an Offset for Social Security Benefits Received by the Children of a Long Term Disability Claimant?

Is it wrong to take an offset for Social Security benefits received by the children of a long term disability claimant? No, says a new decision. And… just because you reinstate benefits does not mean you have to provide…more
| Insurance, Labor & Employment Law

For ERISA Section 502(c) Penalties — Must Plaintiff Prove “Actual Injury”? A Recent U.S. Supreme Court Decision Creates the Argument

These Section 502(c) penalty claims seem to be added to most every ERISA lawsuit... Does a claimant have to prove “actual injury” to win ERISA Section 502(c) penalty claims? MAYBE. Here’s why..…more
| Civil Procedure, Constitutional Law, Labor & Employment Law

ERISA: Court’s Short Checklist to Reduce Plaintiff/Claimant Attorney Fees

Attorney fees in ERISA cases continue to be a challenge. What happens when both sides can claim wins during a case? What is a reasonable hourly rate for Plaintiff’s attorneys?…more
| Civil Procedure, Civil Remedies, Insurance, Labor & Employment Law

ERISA — 9th Circuit: Plaintiffs Can Now Simultaneously Bring Benefit Payment and Equitable Claims

Lane Powell attorney Mike Baylous writes an excellent summary here on big changes to ERISA in the 9th Circuit. Remember that old argument that equitable claims should be dismissed because they are duplicative?…more
| Civil Procedure, Civil Remedies, Finance & Banking, Labor & Employment Law

ERISA: Reviewing What Needs to Be Proved to Establish the Suicide Exclusion

For many reasons, some of the toughest cases to litigate involve the application of the suicide exclusion. There is a growing body of evidence challenging suicide exclusion determinations…more
| Civil Procedure, Commercial Law & Contracts, Conflict of Laws, Insurance, Labor & Employment Law

ERISA (6th Circuit): Mental Nervous Limitations and Dealing with Arguments of “Organic Cause”

You know that most ERISA disability plans contain a 24-month limitation related to mental/nervous disabilities. But what happens when the claimant alleges the mental illness is “organically caused”? Is that enough to…more
| Health, Labor & Employment Law

What Constitutes “Reasonable Efforts” to Inform Plan Participants of Plan Amendments, Which Include a Forum Selection Clause?

You know that many Plans have forum selection clauses. Are they enforceable? YES When a Plan participant claims they “did not know of a plan amendment,” how do you prove the Participant received notice of the amendment? A…more
| Civil Procedure, Commercial Law & Contracts, Finance & Banking, Labor & Employment Law

ERISA (9th Circuit): Denial Letters — Sometimes Forgotten Arguments to Enforce Contractual Limitations Provisions

Must denial letters inform the claimant, seeking ERISA-governed benefits, about the contractual limitations provision? A recent court trend, like with the First, Third and Sixth Circuits, requires denial letters to inform…more
| Commercial Law & Contracts, Insurance, Labor & Employment Law
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