News & Analysis as of

Disability Insurance Denial of Benefits

Littler

Seventh Circuit Case Confirms that “Full and Fair Review” of Disability Claims Requires Disclosure of New Evidence Before Denying...

Littler on

A recent federal appeals court case clarifies that, under ERISA, the regulations governing disability plans’ claims review procedures apply to claims that predate the 2018 changes to the regulations. The decision also serves...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Reverses Award of Attorneys' Fees

In Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., 29 U.S. App. LEXIS 36542 (N.D. Cal. Dec. 10, 2019), the Ninth Circuit reversed a district court's award of attorneys' fees to an ERISA claimant as...more

Proskauer - Employee Benefits & Executive...

District Court Applies Texas Ban on Discretionary Clauses in Insurance Contracts

A federal district court in Louisiana upheld a Texas state law prohibiting insurers from granting themselves discretion to interpret benefit plans when deciding benefit claims. These so-called “discretionary clauses” are...more

Proskauer - Employee Benefits & Executive...

Disability Claims Procedures Should be Updated for New Regulations

As open enrollment approaches for many benefit plans, employers and plans sponsors should check to make sure their claims procedures for disability claims are consistent with regulations that become effective for plan years...more

Seyfarth Shaw LLP

Grounding Deferential Review in California – No Preemption for Discretionary Clause Ban

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

Seyfarth Shaw LLP

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

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

McDermott Will & Emery

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

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

Williams Mullen

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

Williams Mullen on

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

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