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Insurance Claims Denial of Benefits

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - March 2025

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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

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - February 2025

Saul Ewing LLP on

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

Hall Benefits Law

United Behavioral Health Files Cert Petition Over Mental Health Coverage Loss

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United Behavioral Health (UBH) and the Alcatel-Lucent Medical Expense Plan, an employee health plan now owned by Nokia, have filed a petition for a writ of certiorari before the U.S. Supreme Court. They are seeking to...more

Stoel Rives - Notice of Appeal

The Mood Swings on Insurer Bad-Faith in Oregon: An Analysis of the Oregon Supreme Court decision in Moody v. Oregon Community...

The Oregon Supreme Court has long held the legislature did not create a private right of action under the Unfair Claims Settlement Practices Act (ORS 746.230). Policyholders could bring a tort claim against their insurance...more

Rivkin Radler LLP

New York Insurance Coverage Law Update - July 27, 2023

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Southern District Holds That Contractor’s Carrier Has Duty To Defend ConEd Even Though Contractor’s Work Ended Months Before The Accident-A pedestrian tripped and fell on a Bronx sidewalk, and she sued the owner of the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Court Rejects Insurer's Interpretation of its Own Policy Language on Limitations Period

In Spina v. Metro. Life Ins. Co., 2021 U.S. Dist. LEXIS 114887, (D.N.J. June 21, 2021), the court rejected both an insurer's and insured’s interpretation of when proof of loss was due under a long-term care policy and...more

Carlton Fields

ERISA Disability Plan Insurers Score Important Circuit Court Victories

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In recent months, circuit courts across the country have supported insurers’ discretion to deny long-term disability benefits (LTD) under ERISA. Since the beginning of the year, disability plan insurers have prevailed in the...more

Littler

New Mexico Supreme Court Holds Tribal Casino Immune from Workers’ Compensation Claims

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On January 16, 2020, the New Mexico Supreme Court issued its decision in Mendoza v. Isleta Resort and Casino, holding that a tribe does not waive its sovereign immunity to workers’ compensation claims merely by committing in...more

Robinson+Cole ERISA Claim Defense Blog

Remand Directing Change in Standard of Judicial Review Is Not Sufficient Success on the Merits to Support Attorneys’ Fee Award

In Ariana M. v. Humana Health Plan of Texas, Inc., No. 18-20700, 2019 WL 5866677 (5th Cir. Nov. 8, 2019), the Fifth Circuit Court of Appeals rejected a plaintiff’s petition for attorneys’ fees under 29 U.S.C. § 1132(g).  This...more

Troutman Pepper Locke

Insurers Beware: Potential Impact of NJ's Proposed Insurance Fair Conduct Act

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New Jersey legislators are working to enact a law that will provide policyholders with potentially punishing recourse if their insurance carriers mishandle their claims for benefits....more

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