News & Analysis as of

Disability Insurance

The Future of Discretionary Clauses in California Life and Disability Insurance Agreements

by McDermott Will & Emery on

On May 11, 2017, the United States Court of Appeals for the Ninth Circuit reversed a district court ruling, and upheld a California law that invalidates a plan provision that assigns the final determination on benefit payout...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

Health Alert (Australia) March 6, 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: Commonwealth . Administrative Appeals Tribunal 28 February 2017 - Nairn and National Disability Insurance Scheme...more

ERISA: Winning Tactic on Summary Judgment to Prove Claimant Received the Policy: Get Key Evidence into the Administrative Record

You know that to apply an exclusion in a policy, the claims administrator must show that the claimant received the policy. But what happens when the claimant submits a declaration disputing your proof that she received...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

What’s Next Under the Congressional Review Act?

As we reported, the House and Senate have passed a joint resolution under the Congressional Review Act disapproving the SEC Resource Extraction Rule and that President Trump was expected to sign the legislation that...more

CPP Disability Benefits: To Deduct or Not to Deduct

by Field Law on

The standard form SEF 44 endorsement (The Endorsement) was recently interpreted by the Supreme Court of Canada in the case of Sabean v. Portage La Prairie Mutual Insurance Co., 2017 SCC 7. The Endorsement indemnifies an...more

The New ERISA Claims and Appeals Regulations for Disability Benefits

by Jackson Lewis P.C. on

The Employee Benefits Security Administration of the U.S. Department of Labor recently published final regulations governing the ERISA claims and appeals process that will apply to all claims for disability benefits filed on...more

New California Labor and Employment Laws for 2017

by Holland & Knight LLP on

Continuing a trend from recent years, the California Legislature passed, and Gov. Jerry Brown signed into law, numerous labor and employment bills in 2016. Each becomes effective on Jan. 1, 2017, unless otherwise...more

A Question of Timing – Social Security Disability Determinations and the Administrative Record

by Seyfarth Shaw LLP on

Seyfarth Synopsis: Court excludes evidence of Social Security disability award issued after the final decision issued on plaintiff’s claim for plan disability benefits. The decision accentuates the importance of fighting to...more

California Court Finds That Discretionary Clauses in Health Insurance Policies Are Enforceable

In 2011, the California legislature passed Insurance Code Section 10110.6 which bans the use of discretionary clauses in any policy, contract, certificate, or agreement offered, issued, delivered, or renewed, whether or not...more

“Takin’ Care of Business” at Home: Hiring California Household Help

by Seyfarth Shaw LLP on

Seyfarth Synopsis: Have you pondered the implications of hiring help around the house? Here are some legal requirements regarding employment of domestic helpers. Household workers or “domestic helpers” are people who...more

Senate Bill 667 Extends Claim Period Under State Disability Insurance Program

by Ervin Cohen & Jessup LLP on

Effective July 1, 2016, Senate Bill 667 extends from 2 weeks to 60 days the period of time that an employee can reopen a disability insurance claim without having a new 7 day consecutive day waiting period of wage loss. This...more

Defence & Indemnity - April 2016: I. INSURANCE ISSUES

by Field Law on

General information of claims practices and company personnel obtained by an insurer’s in-house counsel is not the type of confidential information that will disqualify the lawyer from acting as Plaintiff’s counsel against...more

San Francisco Enacts Nation’s First Fully Paid Parental Leave Ordinance

Effective January 1, 2017, San Francisco is scheduled to become the first city in the United States to require fully paid parental leave. The Paid Parental Leave Ordinance (the Ordinance) was passed unanimously by San...more

New Law Expands California’s Paid Family Leave and State Disability Insurance

by Ervin Cohen & Jessup LLP on

Approximately 15 years ago California became the first state to provide paid time off to workers to care for a new child or ailing family member. The law, which is funded by required worker contributions, provides for up to...more

California Governor Brown Signs Legislation to Expand Paid Family Leave

by Seyfarth Shaw LLP on

Seyfarth Synopsis: Starting Jan 1, 2017, the amount of benefits paid to employees on paid family leave and state disability will increase substantially, depending on an employee’s income level. The Legislature and...more

Latest Developments from the Connecticut General Assembly: The Labor and Public Employees Committee Speaks: March 2016

The General Assembly’s Labor and Public Employees Committee was active before its March 17, 2016 deadline for approving bills, voting favorably and advancing many bills out of committee....more

Defence & Indemnity - February 2016: Insurance Issues: Portage LaPrairie Mutual Insurance Company v. Sabean, 2015 NSCA 53, per...

by Field Law on

Future CPP benefits fall under the definition of “any policy of insurance” and are therefore deductible from amounts payable by SEF 44 insurers - Portage LaPrairie Mutual Insurance Company v. Sabean, 2015 NSCA 53, per...more

“How Long Will They Get Paid?” — Temporary Total Disability Benefits for Injured Workers

A frequent question employers ask is how long an injured employee is eligible for disability benefits after an injury. If an employee is unable to work following an injury, the employee may request temporary total disability...more

Seventh Circuit Rules ERISA Does Not Preempt State Law Prohibiting Discretionary Clauses

by Wilson Elser on

In Fontaine v. Metropolitan Life Ins. Co., No. 14-1984, 2015 U.S. App. (7th Cir. Sept. 4, 2015), the Seventh Circuit affirmed a U.S. District Court for the Northern District of Illinois decision holding that Illinois’s...more

Best in Law: Tax Ruling Confirms Protocol on Job-Related Judgments

by Best Best & Krieger LLP on

The California Court of Appeal recently confirmed that employment-related settlements or judgments are wages from which employers must withhold payroll taxes. In Cifuentes v. Costco Wholesale Corp., Cifuentes...more

Seventh Circuit Finds that State Insurance Law Applies, Resulting in De Novo Review of Benefit Claim

by McDermott Will & Emery on

On September 4, 2015, the U.S. Court of Appeals for the Seventh Circuit ruled in Fontaine v. Metropolitan Life Insurance Company that the Employee Retirement Income Security Act of 1974, as amended (ERISA), does not preempt...more

Court Finds Against EEOC And Holds Charging Party Who Represented Herself As Being “Totally Disabled” Was Not Qualified To Perform...

by Seyfarth Shaw LLP on

In EEOC v. Vicksburg Healthcare LLC, et al., Case No. 13-CV-895 (S.D. Miss. Aug. 27, 2015), Judge Keith Starrett of the U.S. District Court for the Southern District of Mississippi recently rejected the EEOC’s lawsuit. He...more

Health Alert (Australia) - August 31, 2015

by DLA Piper on

In This Issue: -Judgments; Legislation; and Reports -Excerpts from Judgments New South Wales (NSW) 28 August 2015 - Smith v Pennington [2015] NSWSC 1168 The Supreme Court gave judgement for the...more

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