News & Analysis as of

Employee Retirement Income Security Act (ERISA) Arbitrary and Capricious

Jackson Lewis P.C.

Deferential Review Determinative in Severance Spat

Jackson Lewis P.C. on

In a decision illustrating the importance of a deferential standard of review in an ERISA plan document, the Second Circuit affirmed the dismissal of severance claims by a disabled employee, concluding that the complaint pled...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Court Applies "Reasoned Approach" in Upholding Insurer's Denial of LTD Claim

In Creed v. Hartford Life & Acc. Ins. Co., 2020 U.S. Dist. LEXIS 17613, (S.D. Ohio February 4, 2020), the court applied a "reasoned explanation" approach to hold that the evidence supported an insurer's decision to deny an...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Eighth Circuit Upholds Payment for Out-of-Network Air Ambulance Flight at 150 Percent of Medicare Rates

In Mitchell v. Blue Cross Blue Shield of N.D., 2020 U.S. App. LEXIS 8818 (8th Cir. Mar. 20, 2020), the Eighth Circuit upheld the payment of 150% of Medicare rates for an out-of-network air ambulance flight, although the...more

Proskauer - Employee Benefits & Executive...

Choice-of-Law Plan Provision Enforced As A Matter of Federal Common Law

The Tenth Circuit recently concluded that, as a matter of federal common law, a choice-of-law provision in a long-term disability insurance policy, which was part of the plaintiff’s employer’s ERISA plan, must be enforced...more

Manatt, Phelps & Phillips, LLP

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

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...

Best Practices in Administering Benefit Claims #8 – Facing Litigation of Benefit Claims

Up to now, our blog series has focused on best practices for implementing a plan’s claims and appeals procedure. We shift gears this week to see how following these best practices pays dividends if a participant’s (or...more

Bradley Arant Boult Cummings LLP

Could Possible Predictability Be Coming to Wilderness Therapy Coverage Disputes?

Current trends in litigation regarding wilderness therapy coverage center on motion practice. Courts have been unpredictable with granting or denying defendants’ motions to dismiss and motions for summary judgment, and recent...more

Proskauer - Employee Benefits & Executive...

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

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

Robinson+Cole ERISA Claim Defense Blog

Fifth Circuit Joins Sister Circuits by Overruling Default Deferential Standard of Review

In Ariana M. v. Humana Health Plan of Tex., 2018 U.S. App. LEXIS 5227, *5, 2018 WL 1096980 (March 1, 2018) (“Ariana M. II”), a majority of judges of the U.S. Court of Appeals for the Fifth Circuit, in an en banc decision,...more

Goodwin

Fifth Circuit Overturns Department of Labor Fiduciary Rule

Goodwin on

On March 15, 2018, in Chamber of Com. of the U.S. v. U.S. Dep’t. of Labor (No. 17-10238, 5th Cir. Mar. 15, 2018), the Fifth Circuit entered an order enjoining enforcement of the Department of Labor’s (DOL) fiduciary rule...more

McAfee & Taft

ERISA Plans: Part-time employee entitled to disability benefits

McAfee & Taft on

In Van Steen v. Life Insurance Company N.A., the Tenth Circuit Court of Appeals upheld the grant of long-term disability benefits to an employee working part-time....more

Dechert LLP

ERISA's Fiduciary Rule - Dead Yet? Game Over? Maybe, Maybe Not . . .

Dechert LLP on

It has been a long and winding road for the amended fiduciary regulation (the "Regulation") and the related new and amended exemptions (collectively, the "Rule") of the U.S. Department of Labor (the "DOL") under the Employee...more

Seyfarth Shaw LLP

Timing is Everything: Tenth Circuit Overturns Insurer’s Disability Decision as Arbitrary and Capricious

Seyfarth Shaw LLP on

Even when a claims administrator approves a claim for disability benefits, its job is not done. That principle was again demonstrated in the recent case Owings v. United of Omaha Life Insurance Co., No. 16-3128 (10th Cir....more

Seyfarth Shaw LLP

The U.S. Supreme Court And Workplace Class Actions

Seyfarth Shaw LLP on

Seyfarth Synopsis: As profiled in our recent publication of the 13th Annual Workplace Class Action Litigation Report, the U.S. Supreme Court’s rulings have a profound impact on employers and the tools they may utilize to...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2016

Proskauer Rose LLP on

Editor's Overview - This month, we look at the implications of the two federal district court cases from California that applied the ban on discretionary clauses typically found in ERISA plans to self-insured plans. The...more

Proskauer - Employee Benefits & Executive...

Update on Lawsuits Challenging the U.S. Department of Labor’s Fiduciary Rule

As we previously reported, there are five pending lawsuits challenging the U.S. Department of Labor’s new fiduciary rule. Our Client Alert on the new rule outlines the significance of the rule and the implications of the...more

Ary Rosenbaum - The Rosenbaum Law Firm P.C.

DOL Sued over Fiduciary Rule

One of the questions that I am repeatedly asked is whether the Department of Labor overreached their rulemaking capability by applying their new fiduciary rule to Individual Retirement Accounts (IRAs). I always tell people...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

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