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Benefit Plan Sponsors › Denial of Benefits

Husch Blackwell LLP

When the Payor is Also the Decisionmaker in ERISA Benefits Lawsuits Under 29 U.S.C. § 1132(a)(1)(B)

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When the same health plan administrator both administers a benefit plan and pays the benefits due under the plan, it is considered by courts to have a structural conflict of interest. That conflict of interest is not...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - March 2021

Hinshaw & Culbertson - The LHD/ERISA Advisor on

As we look ahead to 2021, we start our second edition of Hinshaw's LHD/ERISA Advisor by reporting on key cases that closed out 2020. Through The Advisor, our team of attorneys nationwide strive to report on legal developments...more

Manatt, Phelps & Phillips, LLP

Litigating the Scope of ERISA’s ‘Catchall’ Civil Enforcement Provision

Manatt, Phelps & Phillips, LLP on

In recent Employee Retirement Income Security Act of 1974 (ERISA) litigation challenging benefit decisions by plan administrators and fiduciaries, litigants have been pleading closely related claims under multiple ERISA...more

Proskauer - Employee Benefits & Executive...

ERISA Administrative Appeal Barred As Untimely

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The First Circuit held that a plaintiff failed to timely exhaust her administrative remedies under a long-term disability plan because the plan’s 180-day time limit for submitting appeals commenced on the date the plaintiff...more

Proskauer - Employee Benefits & Executive...

Categorical Conflict of Interest Does Not Alter Standard of Review of Benefit Denials

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The Second Circuit held that plaintiffs’ allegations that the defendant suffered from a “categorical potential conflict of interest”—because it both funded the plan and was the claim’s decision-maker—did not affect the...more

Holland & Knight LLP

New ERISA Claims Procedures for Plans Providing Disability Benefits Effective April 1, 2018

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• Administrators of employee benefit plans governed by ERISA should make sure now that the claims procedures contained in their affected benefit plans comply with new regulations applicable to disability benefits. • The...more

Fisher Phillips

Labor Department Boosts Disability Claimant Protections

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

Foley & Lardner LLP

Final Disability Claims and Appeals Regulations – Be Prepared to Comply

Foley & Lardner LLP on

In December 2016, the Department of Labor issued final regulations under ERISA governing claims procedures for group disability plans, which will become effective January 1, 2018. Generally, these regulations were drafted to...more

Seyfarth Shaw LLP

Seventh Circuit Rejects In-Network Providers’ Bid For ERISA Claims Procedures

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Claims by providers seeking to assert the rights of ERISA plan participants have been percolating in courts throughout the country. The Seventh Circuit has now weighed in, rejecting the notion that providers who have payment...more

Fisher Phillips

ERISA Plan Can't Shrink Deadlines Without Providing Notice, Says 3rd Circuit Court of Appeals

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The 3rd Circuit Court of Appeals just ruled that an ERISA plan can’t shorten the deadline for filing a legal action challenging a denial of benefits unless the participant receives written communication of the plan’s altered...more

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