This month’s Friday Five explores decisions (1) upholding a choice of law provision in a long-term disability policy, (2) granting an administrator’s request for reimbursement after overpaying a claimant for years, (3)...more
5/1/2026
/ Appeals ,
Arbitrary and Capricious ,
Choice-of-Law ,
De Novo Standard of Review ,
Disabilities ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Litigation ,
Long Term Disability Insurance ,
Physicians ,
Plan Administrators ,
Subrogation ,
Summary Judgment
This issue of the Friday Five discusses the Fifth Circuit’s strict approach to review deadlines, a court chiding an administrator for relying on evidence not in the record, a court’s refusal to permit discovery into claims...more
4/3/2026
/ Administrative Appeals ,
Disability Benefits ,
Discovery ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Long Term Disability Insurance ,
Medical Records ,
Plan Administrators ,
Rescission ,
Standard of Review ,
Summary Judgment ,
Time Extensions
This month’s Friday Five covers recent decisions on credibility pertaining to long COVID symptoms, weighing of disability evidence, overpayment accounting, preemption of state law claims, and a motion to compel discovery on...more
3/9/2026
/ Coronavirus/COVID-19 ,
Denial of Benefits ,
Discovery ,
Discovery Disputes ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Evidentiary Standards ,
Fiduciary Duty ,
Insurance Claims ,
Insurance Litigation ,
Long Term Disability Insurance ,
Preemption
This month’s Friday Five explores decisions reviewing what evidence is necessary to prove that a condition like long COVID is “sufficiently disabling”, what standard of review applies to benefits under FEGLI, whether an...more
2/6/2026
/ Appellate Courts ,
Arbitrary and Capricious ,
Denial of Benefits ,
Denial of Insurance Coverage ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Evidence ,
Federal Employees ,
Fiduciary Duty ,
Insurance Litigation ,
Long Term Disability Insurance ,
Plan Administrators ,
Plan Participants ,
Policy Terms ,
Standard of Review
This month's Friday Five highlights recent decisions addressing the scope of permissible discovery outside of the administrative record, the admissibility of certain evidence in an LTD benefits termination trial, the role...more
1/12/2026
/ Arbitrary and Capricious ,
Disabilities ,
Discovery ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Evidence ,
Fiduciary Duty ,
Long Term Disability Insurance ,
Scope of Discovery Requests ,
Social Media ,
Social Security Administration (SSA) ,
Standard of Review
This month's Friday Five explores the plaintiff's burden of establishing a continuing disability, when state law claims are expressly preempted by ERISA, and the reasonableness of an administrator's interpretation of a...more
This month’s Friday Five covers recent decisions on supplementation of the administrative record, offset of dependent benefits, full and fair review of claim for benefits, and timing of benefits determination, as well as an...more
11/11/2025
/ Administrative Record ,
Appeals ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Fiduciary Duty ,
Insurance Litigation ,
Judicial Deference ,
Long Term Disability Insurance ,
Plan Participants ,
Standard of Review
This month’s Friday Five explores decisions from around the country discussing differences between the scope of discovery and ability to add documents to the record on a claim for review challenging the denial of LTD...more
10/6/2025
/ Arbitrary and Capricious ,
Choice-of-Venue ,
Denial of Insurance Coverage ,
Disability ,
Disability Benefits ,
Discovery Disputes ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Plan Participants ,
Summary Judgment
This month’s Friday Five explores recent decisions including deference to initial benefits decisions in de novo reviews, the recovery of fees incurred in pre-litigation administrative proceedings, proof of disability due to...more
This month’s Friday Five explores recent ERISA disability benefit decisions involving key issues such as when attorney’s fees should be decided and factors used in determining venue transfer. It also explores retroactive...more
This month’s Friday Five examines recent court rulings on both short- and long-term disability benefits, focusing on key interpretations—including how "earnings" are defined under an employer’s plan....more
This month’s Friday Five explores decisions from around the country discussing the concept of reasonableness in various forms. One court rejected the parties’ proffered definitions of the term “working” and instead determined...more
The April Friday Five covers cases determining futility of exhausting administrative remedies, the nuances of the pre-existing condition exclusion, ERISA preemption, and genuine issue of material fact over an employee’s...more
4/4/2025
/ Administrative Remedies ,
Disability ,
Disability Benefits ,
Employee Benefits ,
ERISA Litigation ,
Fiduciary Duty ,
Insurance Claims ,
Insurance Litigation ,
Motion to Dismiss ,
Policy Exclusions ,
Preemption ,
Summary Judgment
This month’s Friday Five addresses cases covering ERISA preemption, the viability of a claim for benefits where the claimant alleges to have not received notice of a prior claim denial, an affirmance by the Circuit Court of a...more
This month’s Friday Five covers an appellate ruling on a complicated case raising both state and federal claims, an instance of procedural improprieties in the administrative review process informing the court’s substantive...more
2/10/2025
/ Compensation & Benefits ,
Denial of Benefits ,
Disability ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Insurance Claims ,
Insurance Litigation ,
Plan Administrators ,
Retirement Plan ,
Settlement
This month’s Friday Five explores recent decisions including the standard of review for ERISA benefit denials, whether structural conflict entitles a claimant to conflict-of-interest discovery, whether a “relative value...more
This month’s Friday Five explores recent decisions including the impact of a COVID furlough on eligibility for LTD benefits, what constitutes a breach of an employer’s fiduciary duty, what defines total proof of disability or...more
This month’s Friday Five discusses cases addressing the effect of continuing to receive benefits during the period of alleged disability, reliance on an employer’s records in making a disability determination, the...more
This month’s Friday Five explores decisions from around the country discussing differences between the scope of discovery and ability to add documents to the record on a claim for review challenging the denial of LTD...more
This month’s Friday Five explores decisions addressing the burden of proving accidental death, policy language and “any occupation” disability, an interpleader case where the insurer was not dismissed from the case, the...more
7/15/2024
/ Beneficiaries ,
Disabilities ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Litigation ,
Life Insurance ,
Long Term Disability Insurance ,
Medical Records ,
Policy Terms
This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more
6/7/2024
/ Compensation & Benefits ,
Disability ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
ERISA Litigation ,
Fiduciary Duty ,
Health Insurance ,
Insurance Industry ,
Power of Attorney ,
Reimbursements
This month’s Friday Five explores decisions from around the country discussing differences between LTD and LWOP policies, the breadth of discretion available to claims administrators and the always important topic of timely...more
This month’s Friday Five covers the treatment of job-related stress in assessing an attorney’s disability, the requirements surrounding the qualifications of a medical professional to review a claimant’s medical records in...more
4/5/2024
/ Coronavirus/COVID-19 ,
Denial of Benefits ,
Disabilities ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Industry ,
Long Term Disability Insurance ,
Medical Records ,
Plan Administrators
This month’s Friday Five covers cases relating to an alleged conflict of interest leading to discovery, two courts’ opposite treatments of subjective pain complaints, a decision that claims of fraud and misrepresentation were...more
This month’s Friday Five explores decisions regarding the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, an award of attorneys’ fees, costs, and...more
2/2/2024
/ Attorney's Fees ,
Denial of Benefits ,
Disabilities ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Industry ,
Life Insurance ,
Long Term Disability Insurance ,
Overpayment ,
Transfer of Venue