News & Analysis as of

Employee Retirement Income Security Act (ERISA) Policy Exclusions

Keating Muething & Klekamp PLL

Benefits Monthly Minute - March 2024

The March Monthly Minute digs into an Ohio district court ruling that rejected application of a medical plan exclusion, missing participant guidance and related audit concerns, and responses to the Change Healthcare...more

Wiley Rein LLP

‘Violation of Laws Applicable to Employers’ Exclusion Bars Coverage for BIPA Suit

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The United States District Court for the Northern District of Illinois, applying Illinois law, has held that an Employment Practices Liability (EPL) policy’s “Violation of Laws Applicable to Employers” exclusion bars coverage...more

Rivkin Radler LLP

Insurance Update - December 2021

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Our December Insurance Update features four cases. The Minnesota Supreme Court decides if a resident-relative exclusion violates public policy. A Texas appellate court considers, for a second time, if damage from...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor – June 2021: Health Plan May Not Exclude Specific Autism Treatments

The extent to which a health plan may exclude coverage for mental health treatment modalities has become an active area in ERISA litigation. In Doe v. United Behavioral Health, 2021 U.S. Dist. LEXIS 43146 (N.D. Cal. March 5,...more

Rivkin Radler LLP

Judicial Panel on Multidistrict Litigation Centralizes Some COVID-19 Related Insurance Cases

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Judicial Panel on Multidistrict Litigation Centralizes Some COVID‐19 Related Insurance Cases As reported in our September update, the Judicial Panel on Multidistrict Litigation at its July 2020 hearing session requested...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Ninth Circuit Rules Coverage under ERISA Disability Plan Excluded Due to Underlying Medical Condition

In Estate of Maurice v. Life Ins. Co. of N. Am., 792 Fed. Appx. 499 (9th Cir. Cal. Feb. 5, 2020), the Ninth Circuit held that coverage was excluded under an ERISA-governed disability plan ("Plan"), because the evidence in the...more

Bradley Arant Boult Cummings LLP

Could Possible Predictability Be Coming to Wilderness Therapy Coverage Disputes?

Current trends in litigation regarding wilderness therapy coverage center on motion practice. Courts have been unpredictable with granting or denying defendants’ motions to dismiss and motions for summary judgment, and recent...more

Steptoe & Johnson PLLC

Steptoe & Johnson's First Look Winter 2018 Insurance Newsletter

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Employers face liability in a variety of contexts; however, commercial general liability (“CGL”) policies “generally exclude coverage for injury to an employee ‘arising out of and in the course of’ the employment.” In...more

Robinson+Cole ERISA Claim Defense Blog

Ninth Circuit "Interprets" Accident Plan; "Direct and Sole Cause" Doesn't Mean What It Says

In Dowdy v. Metro. Life Ins. Co., 16-15824, 2018 U.S. App. Lexis 12648 (9th Cir. May 16, 2018), the Ninth Circuit ruled that an accident plan that covers “accidental injury that is the Direct and Sole Cause of a Covered Loss”...more

Michigan Auto Law

No-Fault vs. health insurance: What’s the better choice for crash victims?

Michigan Auto Law on

Health insurance is full of landmines for unsuspecting car crash victims, who are subject to ‘auto exclusions,’ coverage limitations, managed care, HMOs and medical pre-approval requirements and ERISA liens....more

Manatt, Phelps & Phillips, LLP

Insurance Recovery Law - July 2014

Second Circuit: Insurer Must Defend Where Factual Allegations Create a Possibility of Coverage - Why it matters: In a recent pro-policyholder decision, the Second Circuit, applying New York law, reminded...more

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