News & Analysis as of

Discretionary Clauses Employee Benefits Denial of Benefits

Spilman Thomas & Battle, PLLC

The Need for Clarity: Standard of Review

In Griffin v. Hartford Life & Acc. Ins. Co., 898 F.3d 371 (4th Cir. 2018), the Fourth Circuit addressed the issue of whether a related company of an entity that enjoyed the abuse of discretion standard also was entitled to...more

Proskauer - Employee Benefits & Executive...

District Court Applies Texas Ban on Discretionary Clauses in Insurance Contracts

A federal district court in Louisiana upheld a Texas state law prohibiting insurers from granting themselves discretion to interpret benefit plans when deciding benefit claims. These so-called “discretionary clauses” are...more

Seyfarth Shaw LLP

Ninth Circuit Holds that ERISA Preempts State Insurance Law Bans on Discretionary Clauses for Self-Funded ERISA Plans

Seyfarth Shaw LLP on

Seyfarth Synopsis: The Ninth Circuit Court of Appeals recently confirmed that ERISA preempts state insurance law bans on discretionary clauses for self-funded ERISA plans....more

Seyfarth Shaw LLP

Grounding Deferential Review in California – No Preemption for Discretionary Clause Ban

Seyfarth Shaw LLP on

Seyfarth Synopsis: In a decision with wide ranging implications, the Ninth Circuit has ruled that a discretionary clause in an employer drafted plan document is subject to, and invalidated by, California’s insurance...more

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