Disability Insurance

News & Analysis as of

ERISA: Public School Teacher’s Employee Benefits Governed by ERISA? Yes!

When you see a claim for disability or life insurance benefits by a public school teacher, you might assume the claim is not governed by ERISA because of the governmental plan exception....more

En Banc Sixth Circuit Rules Against Disgorgement Remedy in Benefits Case

In Rochow v. Life Insurance Company of North America, No. 12-2074 (6th Cir. March 5, 2015), the U.S. Court of Appeals for the Sixth Circuit, sitting en banc, ruled that an insurance company that wrongfully denied benefits to...more

Disgorgement of Profits Not Available for Arbitrary and Capricious Benefits Denial – This Time

Wrongful denial of employee benefits will not expose plan fiduciaries to equitable remedies – such as disgorgement of profits – where restoration of benefits is adequate to make the claimant whole, says the Sixth Circuit in...more

Ninth Circuit Rules That Harmless Procedural Violation Does Not Alter Standard of Review

The Ninth Circuit held that a plan administrator’s failure to render a decision on a long-term disability benefits claim within the period mandated by the plan and ERISA did not alter the standard of review that the court...more

2014 Pension Plan Regulatory Highlights

The start of the new year is as good a time as any to look back at some of the employee benefits regulatory developments of 2014 that were not previously covered in this column. Originally published in Employee Benefit...more

Court Holds That Physician’s State Law Claim For Disability Benefits Is Preempted by ERISA: Hershan v. Unum Group Corporation

A federal court has held that a radiologist’s state law contract claim for certain disability insurance benefits arose under a welfare benefit plan governed by ERISA and was therefore preempted by ERISA. In Hershan v. Unum...more

3 Insurance Pitfalls That Can Put Your Law Practice At Risk

In 2011, I had to deal with a house fire that destroyed my entire home. Traumatic as that was, I learned some valuable lessons from that experience. So many, if act, that they cannot easily be covered in just one article....more

What You Have To Do To Get More Disability After Your Case Closed

You may be entitled to additional disability compensation, even if the adjuster is telling you that your case is closed, if you can show two things. First, you have to show that you have a compensable case that you haven’t...more

The ERISA Litigation Newsletter - October 2014

Editor's Overview - The first article in this month's newsletter focuses on whether specific language in ERISA employer-provided disability insurance plans confer discretionary authority to plan administrators to...more

U.S. District Court Judge Bars Plaintiff’s Individual Disability Claims in Their Entirety by Application of the Doctrine of...

In the Eastern District of Pennsylvania, applying the doctrine of collateral estoppel, a judge adopted the Report and Recommendation of her magistrate judge and granted an individual disability insurer summary judgment on its...more

Pennsylvania Magistrate Judge Recommends That Plaintiff’s Claims Be Barred in Their Entirety by Application of the Doctrine of...

In the Eastern District of Pennsylvania, applying the doctrine of collateral estoppel, a Magistrate Judge issued a Report and Recommendation granting an individual disability insurer summary judgment on an insured’s claims...more

ERISA ATTORNEY FEES – 1st Circuit: Court Remand to Claims Administrator “because the record is insufficient for de novo review” is...

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

Private Disability Insurance: Know the Coverage Details

Many employers provide short- and long-term disability insurance for their employees as an important part of their benefits packages. These policies often make an enormous difference in an employee's quality of life if she is...more

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

What Happens When The Limitations Provision in the Plan As Applied Creates An Impossible Accrual Date?

Approximately six months ago, the Supreme Court of the United States, in Heimeshoff v. Hartford Life & Accident Insurance Co., 134 S. Ct. 604 (2013), addressed whether an employee benefit plan covered by the Employee...more

Final Regulations Allow Retirement Plan Payments for Accident, Health and Disability Insurance

On May 9, 2014, the Internal Revenue Service finalized regulations that govern the tax treatment of payments made by retirement plans to pay accident or health insurance premiums. Under the final regulations, accident or...more

Employee Benefit Plan is Governmental Plan, Even Though Employees are Not, says District Court in 11th Circuit.

It is a deceptively simple statement: Governmental employee benefit plans are exempt from ERISA. 29 U.S.C. § 1003(b)(1). But what about an employee benefit plan of an entity affiliated with a governmental entity, but whose...more

New Rule Allows Disability Insurance Premiums To Be Paid From Qualified Plan Accounts - Employers Will Be Able To Offer Employees...

HIGHLIGHTS - - The Treasury Department and the IRS released final regulations regarding amounts used by a qualified plan to pay for accident or health insurance premiums. Under the regulations, there is one notable...more

After Heimeshoff: Applying An ERISA Plan’s Contractual Limitation of Actions Provision

In Heimeshoff v. Hartford Life & Acc. Ins. Co., 134 S.Ct. 604 (2013), the Supreme Court held that an ERISA plan’s contractual limitations period can be enforced, so long as the claimant has a reasonable time after exhausting...more

A Quick Note About SDI

I have noted some confusion among employers about what information must be given to employees regarding California State Disability Insurance (SDI) and when it must be provided. Employers are currently responsible for...more

Court’s Award of $3.8 Million Raises Questions About the Scope of ERISA Remedies

The U.S. Court of Appeals for the Sixth Circuit has affirmed an unusually large award of $3.8 million in a case involving the denial of long-term disability benefits. In Rochow v. Life Insurance Company of North America, No....more

Supreme Court Affirms Enforceability of Plan Limitations Provision

Resolving a split among the Courts of Appeal, the United States Supreme Court affirmed the Second Circuit in finding enforceable a limitations provision in a long term disability ERISA plan that set forth the length of the...more

High Court Limits Timing Of Certain ERISA Claims

The U.S. Supreme Court unanimously upheld a contractual clause that limited a participant’s ability to file a lawsuit pursuant to a long-term disability (LTD) policy. The contractual limitation was three years from the date...more

Federal Disability Benefits Set to Rise Only 1.5 Percent

People with disabilities and senior citizens can expect a small, 1.5 percent increase in their Social Security and Supplemental Security Income (SSI) benefits in the new year, an even smaller cost of living adjustment than...more

Prevailing Party in Arbitration is Entitled to Post-Award, Prejudgment Interest Under Nevada Law

In Lagstein v. Certain Underwriters at Lloyd’s of London the Ninth Circuit held that Nevada law allows the prevailing party in arbitration proceedings to collect post-award, prejudgment interest....more

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