News & Analysis as of

Employee Benefits Insurance Claims Denial of Insurance Coverage

Carlton Fields

A Collage of Cases: Recent Decisions in Life, Disability, and Accidental Death Insurance Litigation

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ERISA – Attorneys’ Fees and Social Security Disability Offset - In Stark v. Reliance Standard Life Insurance Co., the Tenth Circuit Court of Appeals affirmed a district court order dismissing ERISA claims brought by the...more

Carlton Fields

Litigation Lineup: Recent Decisions in Life and Disability Insurance Run into Policy Lapse, COVID-19, and Conflict of Interest...

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Life Policy Lapse Shortly Before Insured’s Death - In Simon v. USAA Life Insurance Co. (Mar. 29, 2024), the insurer denied death benefits under a term life insurance policy, which had lapsed for nonpayment of premium two...more

Proskauer - Employee Benefits & Executive...

Ninth Circuit Defers to Plan Design and Administrative Discretion on Bounds of Mental Health Coverage

A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...more

Carlton Fields

Court Sheds Light on ERISA’s Fiduciary Exception to Attorney-Client Privilege

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A federal district court in Ohio recently attempted to shed some light on when internal communications between an ERISA plan administrator and its in-house counsel are discoverable and when they are protected by the...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

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