News & Analysis as of

Employee Retirement Income Security Act (ERISA) Standard of Review

Proskauer - Employee Benefits & Executive...

Ninth Circuit Defers to Plan Design and Administrative Discretion on Bounds of Mental Health Coverage

A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...more

Jackson Lewis P.C.

Eighth Circuit: Procedural Irregularity Not a “Gateway” to De Novo Review of Administrator’s Decision to Deny Benefits

Jackson Lewis P.C. on

In McIntyre v. Reliance Standard Life Insurance Company, 972 F.3d 955 (8th Cir. 2020), the United States Court of Appeals for the Eighth Circuit clarified the standard of review to apply where there has been a denial of...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor – June 2021: Sixth Circuit Upholds Denial of Accidental Death Benefits Under "Substantial Factor" Test

In Duncan v. Minnesota Life Ins. Co., 2021 U.S. App. LEXIS 4069 (6th Cir. Feb. 10, 2021), the Sixth Circuit held that an insurer properly denied accidental death benefits on the grounds that a patient's leukemia caused the...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: Tenth Circuit Finds District Court Applied Wrong Standard of Review in Evaluating Plan...

In Lyn M. v. Premera Blue Cross, 2020 U.S. App. LEXIS 23395 (10th Cir. July 24, 2020), the Tenth Circuit held that a district court had applied the wrong standard of review and incorrectly evaluated an ERISA plan...more

Seyfarth Shaw LLP

The 10th Circuit’s New Interpretation of What is Mandated under ERISA’s Notice Requirements May have Far Reaching Effects On Plan...

Seyfarth Shaw LLP on

Seyfarth Synopsis: A recent 10th Circuit decision holding that in order for the abuse of discretion standard to apply in litigation the claims administrator must provide participants with actual notice of discretionary...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: Eleventh Circuit Rules Against Insurer in LTD Case

In Kaviani v. Reliance Std. Life Ins. Co., 2020 U.S. App. LEXIS 3006 (11th Cir. Jan. 31, 2020), the Eleventh Circuit held that an insurer had failed to give sufficient credence to a claimant's self-reports of pain and...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: First Circuit Holds Decision to Deny Accidental Death and Dismemberment Benefits Not an Abuse of Discretion

In Arruda v. Zurich Am. Ins. Co., 951 F.3d 12, 13 (1st Cir. 2020), the First Circuit held that a claims administrator's decision to deny accidental death and dismemberment benefits was not an abuse of discretion where...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

Dechert LLP

Three Strikes and You’re in – Supreme Court to Hear Three ERISA Cases in Upcoming Term

Dechert LLP on

The upcoming term of the U.S. Supreme Court is shaping up to be a busy one with respect to cases arising under the Employee Retirement Income Security Act of 1974 (“ERISA”). There have been other terms with multiple ERISA...more

Littler

Full and Fair Review Requirement under ERISA Gets a Full and Fair Review

Littler on

On July 15, 2019, the U.S. Court of Appeals for the Tenth Circuit touched on the new regulations governing what constitutes a “full and fair review” of a claim for benefits under the Employee Retirement Income Security Act....more

Proskauer Rose LLP

ERISA Newsletter - First Quarter 2019

Proskauer Rose LLP on

Editor's Overview - We often talk about the importance of evaluating whether there are any procedural obstacles to plaintiffs pursuing their ERISA claims, particularly in complex, class actions where it may not be...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

Saul Ewing LLP

The Friday Five: Five Current ERISA Litigation Highlights – February 2019

Saul Ewing LLP on

This month's Friday Five brings a quartet of court of appeals decisions: a pair from the Ninth Circuit relating to standard of review, an Eighth Circuit decision upholding a mental illness limitation, and a Sixth Circuit case...more

Spilman Thomas & Battle, PLLC

ERISA & Employee Benefits Alert: October 2018

Welcome to the first edition of ERISA & Employee Benefits Alert. Our ERISA and Managed Care Group will be providing curated insights and news concerning notable ERISA and managed care issues that highlight current or emerging...more

Holland & Knight LLP

Eighth Circuit Upholds ESOP Administrator's Decision on Death Benefit Claim

Holland & Knight LLP on

• The U.S. Court of Appeals for the Eighth Circuit has affirmed a U.S. District Court's application of deferential standard to the review of an employee stock ownership plan (ESOP) administrator's decision based on broad...more

Proskauer - Employee Benefits & Executive...

Second Circuit Requires Reevaluation of ERISA Attorney Fee Judgment

The Second Circuit determined that a district court erred when it denied an attorney fee award to an ERISA plaintiff who had sought benefits from a plan. In so ruling, the Second Circuit first concluded the district court...more

Kilpatrick

A Recent 5th Circuit ERISA Decision is Not as Far Reaching as it Appears

Kilpatrick on

To reduce the cost of maintaining an ERISA plan and reduce the expense of ERISA litigation, it is helpful to have courts both apply a deferential standard of review and limit the review to the administrative record. If an...more

Jackson Lewis P.C.

The Full Fifth Circuit Will Re-Visit The Standard Of Review In Denial Of Benefits Cases

Jackson Lewis P.C. on

On July 10, the Fifth Circuit Court of Appeals announced that the full Court would re-hear a recent case concerning the applicable standard of review in an ERISA denial of benefits case – which is often outcome-determinative...more

Jackson Lewis P.C.

The Fifth Circuit Calls Into Question Its Standard Of Review In ERISA Denial Of Benefits Cases

Jackson Lewis P.C. on

Explaining that “[a]s any sports fan dismayed that instant replay did not overturn a blown call learns, it is difficult to overcome a deferential standard of review,” a panel of the Fifth Circuit Court of Appeals has called...more

Burr & Forman

Court upholds South Carolina company's benefits plan decision

Burr & Forman on

One of the most important components of the employment relationship is the benefits package an employer is able to offer its employees. Employee benefits have to make business sense for the employer because there’s always a...more

Littler

With the Election (Mercifully) Behind Us, What Will a Trump Administration Mean for Employers?

Littler on

The 2016 Presidential election was arguably the most contentious, unpredictable, and politically polarizing race in this nation's history. The contours of the electoral map changed by the hour in the days leading up to...more

McDermott Will & Emery

Second Circuit Applies Stricter Rules for a Plan Administrator’s Noncompliance with Benefit Claims Regulations

McDermott Will & Emery on

In Depth - On April 12, 2016, the US Court of Appeals for the Second Circuit in Halo v. Yale Health Plan, 2016 WL 1426291 (2d Cir. Apr. 12, 2016), addressed various issues that could arise during a plan administrator’s...more

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