PODCAST: Williams Mullen's Benefits Companion - Best Practices for Reducing ERISA Litigation Risk
ERISA Claims: How Can Benefits Be An Employer’s Burden?
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
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
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
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
On Halloween, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $100,000 settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Doctors’...more
This month’s Friday Five explores a decision ordering an IME prior to a ruling on summary judgment motions, the extent claims reporting records can be sealed, the scope of ERISA preemption in the context of removal, and two...more
This month’s Friday Five explores decisions regarding the timeliness of appeals, the support necessary to sustain an LTD termination decision, a court’s discretion to credit and discredit expert opinions, the circumstances...more
Do you know who is responsible for administering your ERISA employee benefit plans, including who has the authority to resolve claims for benefits under each plan? Do your plan documents reflect your actual administrative...more
This month’s Friday Five explores recent decisions that reflect the precise nature of rules and definitions in the context of ERISA claims. For example, effective dates of CFR code provisions and contractually defined...more
This month's Friday Five covers cases relating to issue preclusion, coverage where the policy terms are inconsistent with the parties’ behavior, application of the abuse of discretion standard of review, applicability of a...more
This month’s Friday Five explores recent decisions that illustrate the importance of the administrative record built by a claims administrator, and the impact that the depth and thoroughness of the record will have on...more
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: (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
In Byerly v. Std. Ins. Co., 2021 U.S. App. LEXIS 2937 (5th Cir. Feb. 2, 2021), the Fifth Circuit determined that a claimant, whose leg was amputated after he stubbed his toe, did not suffer a qualifying loss under his group...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
In Adkins v. Life Insurance Company of North America, 2021 U.S. Dist. LEXIS 37847 (E.D. Wash., March 1, 2021), a Washington district court blocked a plaintiff’s attempt to conduct discovery into the claim review history of an...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
As we enter the final months of 2020, this is a time to reflect on a year of unprecedented challenges. Although Covid-19 changed our lives in many ways, it did not halt new legal developments in the life, health and...more
This month’s Friday Five discusses cases that address the admissibility of an expert opinion, the calculation of pre-disability earnings, the definition of disability earnings, circumstances where a court will transfer venue...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
In Creed v. Hartford Life & Acc. Ins. Co., 2020 U.S. Dist. LEXIS 17613, (S.D. Ohio February 4, 2020), the court applied a "reasoned explanation" approach to hold that the evidence supported an insurer's decision to deny an...more