In Ligotti v. United Healthcare Services, 2021 U.S. Dist. LEXIS 106992 (S.D. Fla., June 8, 2021), a Florida district court held that a health care provider challenging claim denials on behalf of his patients cannot satisfy...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
In Lyn M. v. Premera Blue Cross, 2020 U.S. App. LEXIS 23395 (10th Cir. July 24, 2020), the Tenth Circuit held that a district court had applied the wrong standard of review and incorrectly evaluated an ERISA plan...more
10/14/2020
/ Appeals ,
Denial of Insurance Coverage ,
Dependents ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Medical Necessity ,
Mental Health ,
Plan Administrators ,
Reversal ,
Reversible Error ,
Standard of Review ,
Summary Judgment
In Fortier v. Hartford Life & Accident Ins. Co., 916 F.3d 74 (1st Cir. 2019) the U.S. Court of Appeals for the First Circuit clarified ERISA's timing requirements with respect to appealing an adverse benefits determination...more
2/12/2020
/ Administrative Appeals ,
Adverse Employment Action ,
Appeals ,
Denial of Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Equitable Relief ,
Exhaustion Doctrine ,
Long Term Disability Insurance ,
Motion to Dismiss ,
Notice Prejudice Rule ,
Plan Administrators ,
Reaffirmation ,
Right To Appeal ,
Statute of Limitations ,
Substantial Compliance
In Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., 29 U.S. App. LEXIS 36542 (N.D. Cal. Dec. 10, 2019), the Ninth Circuit reversed a district court's award of attorneys' fees to an ERISA claimant as...more
2/5/2020
/ Abuse of Discretion ,
Appeals ,
Attorney's Fees ,
Calculation of Damages ,
Denial of Benefits ,
Disability Benefits ,
Disability Insurance ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Motion for Summary Judgment ,
Plan Administrators ,
Prevailing Party ,
Rejection of Settlement Offers ,
Remand ,
Reversal ,
Settlement Offer
In Hall v. Rite Aid Corp., the Fourth Appellate District reversed the trial court’s decertification of a putative class of cashiers who challenged their employer’s policy of requiring them to stand while checking out...more