Courts have long held that ERISA plan administrators need to consider the evidence considered and the determination made by the Social Security Administration (SSA) in evaluating disability benefits claims. But the Eleventh...more
You already know that a Social Security disability (SSDI) decision should be considered in the context of deciding whether the claimant is disabled under the terms of the disability policy....more
An Insurance Commissioner’s non-binding opinion banning discretionary language in an ERISA governed plan has no effect.
Here’s the case of Frazier v. Life Insurance Company of North America, __ F.3d __ (6th Cir. August...more
In This Issue:
- Supreme Court Update: Where Plan Reimbursement Or Recovery Terms Are Ambiguous Or Silent,Equitable Doctrines May Fill The Gaps:
US Airways, Inc. v. McCutchen, 569 U.S. ___ (2013).
What happens when an ERISA claimant submits contradictory statements to the Social Security Administration and the ERISA plan administrator? Can these contradictory statements be used to deny the ERISA claim? YES....more
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