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 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 that range from the effect on disability benefits when medical records are not provided after two appeals, to a case that examines how an award of death benefits is...more
This month’s Friday Five addresses two cases involving disability claims that touch on Covid-19, a Circuit Court ruling for an insurer, a district court ruling that a 20-year-old regulatory settlement precluded an insurer...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
4/4/2022
/ Breach of Contract ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Claims ,
Insurance Litigation ,
Medical Examinations ,
Mental Health ,
Overpayment ,
Policy Terms