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Health Insurance Breach of Duty

Arnall Golden Gregory LLP

Appeals Court Revives AGG Class Action Against UnitedHealth Group for Federal Mental Health Parity Law Violations

The United States Court of Appeals for the Ninth Circuit ruled on April 11, 2024, that AGG’s class action lawsuit against UnitedHealth Group and its subsidiaries for the wrongful and systematic denial of mental health and...more

Seyfarth Shaw LLP

Drugmaker Sued for…Overpaying for Drugs? Lawsuit Ushers in Expected Wave of Welfare Fiduciary Litigation

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The first complaint was filed in what is expected to be a wave of litigation alleging breach of fiduciary duty in selecting and monitoring welfare plan vendors. While the facts of this particular case may make it somewhat...more

ArentFox Schiff

Health Insurers Sued Over Use of Artificial Intelligence to Deny Medical Claims

ArentFox Schiff on

With the surge of interest in artificial intelligence (AI), it should be no surprise that health insurers have come under scrutiny concerning their use of AI predictive tools to deny medical insurance claims. The question...more

Littler

Fourth Circuit Establishes New Standards for Plaintiffs Seeking Unjust Enrichment as an Equitable Remedy under ERISA

Littler on

The United States Court of Appeals recently shed light on when—and under what conditions—a plaintiff may seek a monetary recovery under § 502(a)(3) of the Employee Retirement Income Security Act (ERISA). Section 502(a)(3)...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - February 2022

The February Monthly Minute examines the DOL’s recent focus on mental health parity compliance, the Hughes vs. Northwestern University retirement plan fee litigation, and the latest COVID-19 testing coverage guidance....more

Wiley Rein LLP

Insured Barred From Settling Without Insurer’s Consent Absent Breach of Duty to Defend But Insurer Must Exercise Good Faith in...

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The United States District Court for the District of South Dakota, applying South Dakota law, has held that an insured healthcare system was barred from settling without its healthcare liability insurer’s consent where the...more

Morrison & Foerster LLP - Left Coast Appeals

This Week at The Ninth: PowerPoints and Payday Loans

This week, the Court revives an ERISA claim and compels arbitration of a dispute over tribal internet payday loans. WARMENHOVEN v. NETAPP, INC. The Court holds that PowerPoint presentations did not constitute plan...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor – June 2021: Court Blocks Plaintiff's Attempt to Conduct Discovery Into Claim Review History of Medical...

In Adkins v. Life Insurance Company of North America, 2021 U.S. Dist. LEXIS 37847 (E.D. Wash., March 1, 2021), a Washington district court blocked a plaintiff’s attempt to conduct discovery into the claim review history of an...more

Akerman LLP - Health Law Rx

Second Circuit Sends PBM “Clawback” Litigation Plaintiffs Back to the Drawing Board

Anthem, Inc., (Anthem) and Express Scripts, Inc., (Express Scripts) had a big win this week, creating another setback for plaintiffs filing ERISA lawsuits against pharmacy benefits managers (PBMs)....more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: District Court Holds that Plan Administrator Was ERISA Fiduciary

In Technibilt Grp. Ins. Plan & Technibilt, Ltd v. Blue Cross & Blue Shield of North Carolina (W.D. N.C., Feb. 3, 2020), a North Carolina district court held that a plan administrator was an ERISA fiduciary for the purpose of...more

Rivkin Radler LLP

Employee Relations Law Journal – From the Courts

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North Carolina District Court Permits Plan’s Lawsuit Against Third Party Administrator to Continue A federal district court in North Carolina has ruled that a plan subject to the Employee Retirement Income Security Act of...more

Rivkin Radler LLP

Employee Benefit Plan Review – From the Courts

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Second Circuit Affirms Decision Rejecting ERISA Claims for Retiree Health Benefits The U.S. Court of Appeals for the Second Circuit has affirmed a district court’s decision dismissing claims under the Employee Retirement...more

Proskauer Rose LLP

ERISA Newsletter - Third Quarter 2019

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In this edition of our Newsletter, we take a look at a pair of cases that, while unrelated, together remind us of the importance of having clear plan rules in place that reflect the plan sponsor’s intention. The first article...more

Dickinson Wright

Highlights from Wit v. United Behavioral Health

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Earlier this month, on March 5, 2019, the United States District Court in the Northern District of California filed its 106-page Findings of Fact and Conclusions of Law in the class action Wit v. United Behavioral Health...more

K&L Gates LLP

K&L Gates Triage: Important Takeaways from Omega Hospital, LLC v. United Healthcare Services, Inc.

K&L Gates LLP on

In this episode, Gary Qualls discusses a recent development in payer litigation which implicates a number of recurring issues often raised in Employee Retirement Income Security Act (ERISA) cases. Specifically, a federal...more

Proskauer Rose LLP

ERISA Newsletter - Fourth Quarter 2018

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As we closed the door on 2018, we were met by two surprising decisions—one from a panel of the Second Circuit addressing employer stock drop litigation, and one from a federal district court in Texas declaring the entire...more

FordHarrison

Home Care Agencies Sued for Illegal Use of Captive Insurance Company

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Class action attorneys recently filed a first-of-its-kind class action against Edison Home Health Care (“Edison”) and Preferred Home Care of New York (“Preferred”) alleging that the home care agencies used a “captive”...more

Kilpatrick

Typical Administrative Procedures Lead to Unfavorable Court Decision

Kilpatrick on

It is not uncommon for employers to place the burden on employees of informing the employer when a dependent becomes ineligible for a benefit.  Plan documents and SPDs should provide notice that if these rules are not...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2015

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Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more

Stinson - Benefits Notes Blog

Claims Administrators can be Liable for Violations of the Mental Health Parity Act

The Mental Health Parity and Addiction Equity Act (MHPA) requires health plans to treat mental health and physical health benefits in much the same manner and precludes restrictions on mental health benefits that are not also...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - September 2015

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Editor's Overview - It has been a little more than one year since the U.S. Supreme Court altered the legal landscape for litigating ERISA breach of fiduciary duty claims relating to the investment in employer stock...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - April 2015

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Editor's Overview - In this month's Newsletter, Robert Rachal discusses recent "church plan" rulings where some federal judges have declined to give deference to long-standing, consistent guidance from the Internal...more

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