Lane Powell PC - ERISA Law Blog

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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
| Civil Procedure, Civil Remedies, Labor & Employment Law, Insurance

ERISA ATTORNEY FEES – 1st Circuit: Court Remand to Claims Administrator “because the record is insufficient for de novo review” is “sufficient success on the merits” to Award Attorney Fees?

You have seen this issue before: The court remands the ERISA-governed long term disability claim for further consideration by the claims administrator because the administrative record was insufficient for de novo review…more
| Administrative Law, Civil Procedure, Civil Remedies, Labor & Employment Law

ERISA: 6th Circuit — Benefit Denial Letters: Include The Time Limit For Judicial Review Or Lose Contractual Limitations Defense

Does your ERISA claim benefit denial letter preserve the contractual limitations defense? If your denial letter fails to expressly state the contractual limitations timeframe, it might not preserve that defense…more
| Civil Procedure, Commercial Law & Contracts, Labor & Employment Law

ERISA (8th Circuit): Over-The-Counter Vitamin Supplements Trigger Pre-Existing Condition Exclusion

What sort of “medical treatment” triggers the pre-existing condition exclusion in an ERISA-governed disability policy?…more
| Civil Procedure, Labor & Employment Law, Health, Insurance

More Disabled Employees But Fewer Employees Covered With Long Term Disability Coverage

Here is a recent news item showing the scope of the employee disability problem. In a nutshell..…more
| Labor & Employment Law

ERISA (1st Cir.): Lack of Cooperation During Functional Capacity Evaluation Bars Disability Claim

But what happens when the claimant refuses to perform tasks requested, or does not try hard enough during the FCE?…more
| Civil Procedure, Labor & Employment Law

ERISA: “Derivative Standing” Allows Medical Provider To Obtain Reimbursement From ERISA Plan

Medical providers often have a patient/ERISA plan participant assign rights under an ERISA health care plan to allow the medical provider to seek payment for medical services provided…more
| Commercial Law & Contracts, Constitutional Law, Labor & Employment Law, Health, Insurance

ERISA: Self-Funded Benefit Plans May Not Have To Cover Same-Sex Spouses?

You already know that the Defense of Marriage Act (DOMA), which prohibited recognition of same-sex marriages, was declared unconstitutional. United States v. Windsor, 133 S.Ct. 2675 (2013)…more
| Civil Procedure, Constitutional Law, Labor & Employment Law, Family Law, Health

ERISA 8th Circuit: Deciding Who Is The Beneficiary — The Abuse Of Discretion Standard Trumps The Substantial Compliance Doctrine

Sometimes determining the correct beneficiary for ERISA-governed life insurance benefits can present real challenges. Can the deceased’s will prove the deceased’s intent designating the correct beneficiary? It depends…more
| Civil Procedure, Labor & Employment Law, Insurance, Wills, Trusts, & Estate Planning

ERISA – 9th Circuit: Are There Advantages To De Novo Review Versus Arbitrary And Capricious Review?

You already know that plans that contain “discretionary language” should enjoy a more deferential review by the trial court. But when the plan administrator decides and funds the benefit decision, courts view this as a…more
| Civil Procedure, Labor & Employment Law

ERISA: Plans Waive Defenses If Not Asserted In Administrative Process

Does the claim administrator waive the timeliness defense if it failed to deny the claim on that basis during administrative review? YES! Here is a nice case that summarizes the point, and the status of waiver in the…more
| Civil Procedure, Labor & Employment Law, Finance & Banking

ERISA Penalty Claims — How To Handle Them

Are you seeing more ERISA Plaintiffs asserting claims seeking penalties for delayed production of ERISA-related documents? 29 U.S.C. 1132(c)(1) allows the Court to impose penalties of up to $110 per day for delays in…more
| Civil Procedure, Labor & Employment Law, Finance & Banking

ERISA: 9th Circuit — Does “Reopening” A Claim, AFTER The Statute of Limitations Has Run, Waive That Defense?

ERISA claims administrators sometimes are asked to “reopen” a claim, after appeal denial, to consider additional information. How does “reopening” a claim affect the statute of limitations defense? If the statute…more
| Civil Procedure, Labor & Employment Law

ERISA (7th Cir.): Beneficiary and Attorney Who Ignore Subrogation Lien for Medical Bills Paid by ERISA Plan “Better Call Saul”

You have seen this one before: The ERISA plan pays hundreds of thousands of dollars in medical bills and secures an equitable lien. Then, the ERISA plan beneficiary settles a tort claim, but refuses to reimburse the ERISA…more
| Civil Remedies, Labor & Employment Law, Personal Injury, Health

ERISA – 2nd Circuit: Reversible Error To Deny Successful Claimant’s Attorney Fees Solely Because There Was No Evidence of Bad Faith

Can a court deny a successful ERISA claimant’s attorney fees solely because there is no evidence of bad faith? NO…more
| Labor & Employment Law, Insurance
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