This month’s Friday Five covers cases relating to augmentation of the administrative record following new rationales, attempted alternative ERISA causes of action, untimely ERISA claims, plans governed by ERISA even in the...more
This month’s Friday Five covers cases relating to the interpretation of time periods for claims under life insurance and disability plans, a situation where three separate administrators handled a disability benefits claim...more
This month’s Friday Five covers cases relating to interpretation of ambiguous policy terms, evaluation of claimant’s expert witness, inclusion of law firms as appropriate parties from whom plan administrators may seek...more
This month’s Friday Five addresses cases considering: (1) whether monetary relief in the amount of lost benefits is an available remedy for breach of fiduciary duty; (2) the validity of an ex-spouse’s beneficiary designation...more
This month’s Friday Five covers cases relating to interpretation of regulatory deadlines, the enforceability of discretionary clauses, circuit courts going both ways on appeals from summary judgment rulings in favor of plans,...more
This month’s Friday Five covers cases relating to an award of attorney’s fees (but not) costs, class certification in an ERISA benefits case, a court finding that a physician claimant was disabled from his own occupation, a...more
This month’s Friday Five covers cases relating to a claimant’s second chance when a lawyer misses a court deadline, whether certain voluntary benefits fall within a broader ERISA plan, a court deciding that an insurer was...more
This month’s Friday Five covers cases relating to: (1) whether claim administrators can recover overpayments through a breach of contract claim under state law; (2) whether claim administrators can rely solely on a claimant’s...more
4/4/2022
/ Breach of Contract ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Claims ,
Insurance Litigation ,
Medical Examinations ,
Mental Health ,
Overpayment ,
Policy Terms
This month’s Friday Five explores recent decisions tackling a myriad of issues, including: (1) whether reclassification of a claimant’s health status constitutes an adverse benefit determination; (2) whether remand is the...more
This month’s Friday Five explores recent decisions that elucidate the difference between disputes that call upon the discretion and judgment of a court compared to disputes where the court is called upon to follow...more
This month’s Friday Five covers cases relating to: (1) whether a plaintiff may be entitled to AD&D benefits when their spouse died of an illegal drug overdose; (2) when a plaintiff can supplement the administrative record...more
This month’s Friday Five discusses cases that focus on what information properly constitutes the administrative record before the court on which a decision must be based. One case explores the ERISA Records Rule which limits...more
This month’s Friday Five highlights equitable claims under ERISA, the applicability of an arbitration provision that fails to allow for plan-wide remedies, and the ongoing discretion in interpretation and application of...more
This month’s Friday Five covers cases relating to implied terms in disability definitions, retrieving mistakenly paid pension payments, claims from former beneficiaries who were allegedly and improperly excluded from...more
This month’s Friday Five covers cases relating to: (1) whether a state statute prohibiting discretionary authority in disability benefit plans applies to non-state residents; (2) how a court may weigh multiple denials and...more
This month’s Friday Five covers cases relating to: (1) whether an insurer may seek reimbursement of LTD benefits after a plaintiff obtains a tort settlement, and the scope of discovery on class claims regarding the same; (2)...more
This month’s Friday Five covers cases relating to the exhaustion of administrative remedies set forth only in a denial of benefits letter, the scope of information required to be provided to medical reviewers, whether...more
This month’s Friday Five highlights both circuit and district court opinions on the scope of ERISA preemption, discretionary review and exhaustion of administrative remedies....more
This month’s Friday Five covers cases relating to disputes between beneficiaries to life insurance policy proceeds, an insurer’s use of independent medical reviewers and in-house nurses to evaluate claims, the preexisting...more
This month’s Friday Five covers federal guidelines for extension of ERISA claim deadlines due to the pandemic, as well as cases relating to: whether an expert witness who changes their opinion throughout the course of the...more
This month’s Friday Five discusses cases that address the meaning of “active, full-time employee,” whether remand is required where an improper standard of review was applied, the standard for capacity in reference to a...more
This month’s Friday Five covers cases relating to: what constitutes adequate consideration by an insurer of a disability claimant’s Social Security disability award; an analysis of various factors for consideration when a...more
This month’s Friday Five covers recent cases addressing: (1) the validity of a judgment that includes retroactive “any occupation” benefits where no administrative determination on those benefits has been made; (2) the...more
This month’s Friday Five covers cases relating to personal liability of medical reviewers, when notice violations arise to a claim for relief, how plans must delegate discretionary authority, the rights of plans to terminate...more
This month’s Friday Five discusses cases that explore some fundamental principles of disability benefit litigation. While players and fans return to the favorite fall pastime of football, albeit in the “new normal” under...more