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Employee Retirement Income Security Act (ERISA) › Insurance Industry › Appeals

King & Spalding

Fifth Circuit Finds No Private Right of Action for Providers to Enforce Surprise Billing Awards

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On Thursday, June 12, 2025, a panel of the United States Court of Appeals for the Fifth Circuit issued two rulings construing parts of the No Surprises Act (NSA) to limit judicial review of arbitration awards issued under the...more

Holland & Knight LLP

Tenth Circuit Upholds Great-West Stable Value Win in ERISA Case - Finds That Great-West Not a Fiduciary or Liable as a...

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• The U.S. Court of Appeals for the Tenth Circuit affirms a District Court's holding that Great-West Life & Annuity Insurance Co. was not a fiduciary with respect to its stable value fund, even though it announced the fund's...more

Winstead PC

Bullet Proofing Your Claims Procedures

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Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more

Bass, Berry & Sims PLC

Action Needed by Certain ERISA Plans – New Disability Claims Procedures Apply Beginning April 2018

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In January 2018, the U.S. Department of Labor (DOL) announced that final regulations affecting how some ERISA plans process claims and appeals will apply beginning April 1, 2018. As explained below, the final regulations...more

Seyfarth Shaw LLP

Timing is Everything: Tenth Circuit Overturns Insurer’s Disability Decision as Arbitrary and Capricious

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Even when a claims administrator approves a claim for disability benefits, its job is not done. That principle was again demonstrated in the recent case Owings v. United of Omaha Life Insurance Co., No. 16-3128 (10th Cir....more

Proskauer - Employee Benefits & Executive...

Oregon State Court of Appeals Recognizes Federal Slayer Law

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Oregon, like many states, has on its books a “slayer statute,” which generally prohibits a slayer or abuser of a decedent from obtaining benefits by virtue of the death of the decedent. The parents of Julianne Herinckx...more

Faegre Drinker Biddle & Reath LLP

U.S. Third Circuit Allows Providers to Sue Health Insurers Directly

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For many years, the United States Court of Appeals for the Third Circuit was out of step with its sister Courts of Appeal when it came to the issue of suing health insurance companies for failing to cover the medical expenses...more

Baker Donelson

Court of Appeals to Plan Administrators: Inform Claimants of Time Limits on Front End of Discussions

Baker Donelson on

Recently, in Mirza v. Insurance Administrator of Am., Inc., __ F.3d__ (3d. Cir. 2015), the United States Court of Appeals for the Third Circuit was asked to determine whether plan administrators are required to include a...more

Eversheds Sutherland (US) LLP

Insurance Industry Sweeps Retained Asset Account Doubleheader

Eversheds Sutherland (US) LLP on

On August 26, the U.S. Court of Appeals for the First Circuit held in Vander Luitgaren v. Sun Life Ass. Co. of Canada, No. 13–2090, 2014 WL 4197947 (1st Cir. Aug. 26, 2014), that an insurer, acting as a claims administrator,...more

Carlton Fields

First Circuit Finds for Life Insurer in ERISA Class Action Challenging Retained Asset Accounts to Pay Life Insurance Benefits

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In a unanimous panel decision, the U.S. Court of Appeals for the First Circuit reversed a trial court’s ruling that the defendant, Unum Life Insurance Company of America (Unum), had breached fiduciary duties under the...more

Pierce Atwood LLP

First Circuit Upholds Use of Retained Asset Accounts in ERISA Class Action

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On July 2, 2014, a unanimous panel of the United States Court of Appeals for the First Circuit held that Unum Life Insurance Company’s practice of using Retained Asset Accounts (RAAs) to pay death benefits claims on group...more

K&L Gates LLP

In an Opinion with Far-Reaching Implications, the Second Circuit Finds Insurance Coverage for an ERISA Claim

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When a general liability policy expressly provides coverage for employee benefits liability and the plaintiff in the underlying suit alleges a violation of the Employee Retirement Income Security Act of 1974 (“ERISA”), does...more

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