Making Effective Use of the Claims/Disputes Process
In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more
Plaintiffs seeking recovery of group disability benefits under ERISA-governed plans routinely argue that claim fiduciaries failed to adequately consider and/or account for decisions by the Social Security Administration...more
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
This week in our blog series on best practices in administering benefit claims, we discuss the importance of knowing and, importantly, understanding the laws governing benefit claim administration. Section 503 of ERISA...more
This month's Friday Five covers three cases that address issues that can be critical for LTD insurers litigating matters in federal court, specifically issues related to injunctions, statutes of limitations and ERISA...more
One court recently analyzed the extent to which an insurer can rely on a reviewing physician over a treating physician, and why it is important to take note of any recommendations made by the reviewing physician....more
Much has been written about the Department of Labor’s final rule regarding disability benefit claims procedures (the “Final Rule”), which took effect on April 2, 2018. And by now, most employers – and all disability insurance...more
Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more
PAID Underway. On April 3, the Department of Labor’s (DOL) Wage and Hour Division (WHD) officially launched its Payroll Audit Independent Determination (PAID) program to encourage employers to voluntarily resolve potential...more
On April 1, 2018, a new Department of Labor regulation that modifies the procedures ERISA-governed plans must use to evaluate disability claims took effect....more
Earlier this year the US Department of Labor ("DOL") announced that regulations specifying new procedural requirements for administration of disability benefits claims under plans that are subject to the Employee Retirement...more
After much delay and uncertainty, the U.S. Department of Labor’s final rule on disability benefit claims procedures is set to become effective April 1. The rule, which applies to ERISA employee benefit plans (including...more
On April 1, 2018, employer sponsored plans subject to ERISA and providing a benefit contingent on a disability determination will need to comply with new rules finalized by the Department of Labor (DOL). The new rules were...more
U.S. Department of Labor final regulations for disability claims under the Employee Retirement Income Security Act (ERISA) plans become effective on April 1, 2018. Plan sponsors should do two things: (1) review plans that...more
Effective for any claims made on or after April 1, 2018, the decision to grant or deny benefits under an ERISA-covered plan will be governed by new rules. Since insured plans are subject to the claims procedures set forth...more
• Administrators of employee benefit plans governed by ERISA should make sure now that the claims procedures contained in their affected benefit plans comply with new regulations applicable to disability benefits. • The...more
Effective for claims filed after April 1, 2018, employee benefit plans governed by the Employee Retirement Income Security Act (ERISA) must comply with the US Department of Labor's new disability claims regulations....more
The U.S. Department of Labor (DOL) recently announced that the revised Employee Retirement Income Security Act of 1974 (ERISA) disability benefit claim regulations will apply to claims filed on and after April 1, 2018. The...more
The DOL’s revised ERISA disability claims procedures regulations will be taking effect early next month, and plan sponsors should take a hard look at plan processes over the next few weeks to ensure compliance. ...more
The Department of Labor (DOL) issued final regulations that add to the existing requirements for disability benefits claims. The regulations add procedural steps and participant rights that must be included in a plan’s...more
In January 2018, the U.S. Department of Labor (DOL) announced that final regulations affecting how some ERISA plans process claims and appeals will apply beginning April 1, 2018. As explained below, the final regulations...more
Many ERISA-covered employee benefit plans will need to be amended effective April 2. Companies may need to update their Employee Retirement Income Security Act of 1974 (ERISA)-covered employee benefit plans to comply with...more
After a three-month delay, the Department of Labor’s new regulations governing claims procedures for disability benefits under ERISA plans will become effective on April 1, 2018. The delay was implemented to provide an...more
The Department of Labor issued the final disability claims regulations on December 16, 2016. These regulations are effective for all claims filed on or after April 1, 2018. The Department felt the update was needed to...more
The U.S. Department of Labor announced earlier this year that the effective date for employee benefit plans to comply with its new final rule on disability claims procedures is April 1, 2018. The rule applies to claims for...more