Executive employment relationships are rarely permanent. When an executive or other senior-level employee terminates employment, companies often must deal with difficult tax, equity, and benefits issues that arise in...more
This month’s Friday Five explores recent decisions including deference to initial benefits decisions in de novo reviews, the recovery of fees incurred in pre-litigation administrative proceedings, proof of disability due to...more
This month’s Friday Five explores recent decisions including the impact of a COVID furlough on eligibility for LTD benefits, what constitutes a breach of an employer’s fiduciary duty, what defines total proof of disability or...more
This month’s Friday Five discusses cases addressing the effect of continuing to receive benefits during the period of alleged disability, reliance on an employer’s records in making a disability determination, the...more
This month’s Friday Five explores decisions from around the country discussing differences between the scope of discovery and ability to add documents to the record on a claim for review challenging the denial of LTD...more
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
This month’s Friday Five explores decisions from around the country discussing differences between LTD and LWOP policies, the breadth of discretion available to claims administrators and the always important topic of timely...more
This month’s Friday Five covers the treatment of job-related stress in assessing an attorney’s disability, the requirements surrounding the qualifications of a medical professional to review a claimant’s medical records in...more
In Steigleman v. Symetra Life Ins. Co., 2023 WL 7413668 (D. Ariz. 2023), a court considered whether a package of various welfare benefit insurance policies an individual business owner arranged for herself and her employees...more
This month’s Friday Five explores decisions regarding the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, an award of attorneys’ fees, costs, and...more
On Halloween, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $100,000 settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Doctors’...more
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
Recently, the Ninth Circuit addressed and further clarified the requirement of a “full and fair review” in the context of a long-term disability benefit case under the Employee Retirement Income Security Act (ERISA). In...more
In Avenoso v. Reliance Standard Life Insurance Company, No. 21-1772, 2021 U.S. App. LEXIS 35264 (8th Cir. Nov. 30, 2021), the Eighth Circuit clarified its position in a circuit split over the proper judicial procedure for...more
In Hall v. Aetna Life Ins. Co., 2021 U.S. Dist. LEXIS 117331 (N.D. Cal. June 23, 2021), a California district court held that an ERISA claim administrator properly terminated long-term disability (LTD) benefits after the...more
In Calkin v. United States Life Ins. Co., 2021 U.S. Dist. LEXIS 82110 (S.D. TX., April 29, 2021), a Texas district court affirmed the insurer’s denial of LTD benefits, holding that while a claimant established diagnoses, he...more
In DeBold v. Liberty Life Assur. Co. of Bos., 2021 U.S. Dist. LEXIS 120153 (D. Mass, June 28, 2021), a district court held that an ERISA plan administrator could reduce an insured's monthly long-term disability (LTD) benefit...more
In Ruderman v. Liberty Mut. Grp., Inc., 2021 U.S. Dist. LEXIS 40516 (N.D.N.Y. Mar. 4, 2021), a New York district court held that just because an insurer might have been likely to deny a claim does not excuse a claimant's...more
This month’s Friday Five covers cases relating to disputes between beneficiaries to life insurance policy proceeds, an insurer’s use of independent medical reviewers and in-house nurses to evaluate claims, the preexisting...more
In 2010, Chief Justice John Roberts observed that that ERISA is “an enormously complex and detailed statute.” Conkright v. Frommert, 559 U.S. 506, 509 (2010)....more
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
The claimant, Martinez, was a disabled veteran who suffered from multiple sclerosis. In September 2010, Martinez became a participant in his employer's group LTD benefits plan (the "Plan"). When his health deteriorated in...more
Ninth Circuit Affirms Decision Rejecting Suit Seeking Early Retirement Benefits - The U.S. Court of Appeals for the Ninth Circuit has affirmed a district court’s decision rejecting a plaintiff’s lawsuit seeking to overturn...more
In Demko v. Unum Life Ins. Co. of America, 2019 U.S. App. LEXIS 31102 (9th Cir. Oct. 15, 2019), the Ninth Circuit affirmed Unum Life's determination that a Hollywood executive diagnosed with fibromyalgia was not disabled from...more
The Fifth Circuit concluded that a plan’s three-year contractual limitations period began to accrue when a beneficiary received a letter in 2008 that prominently displayed on the first page the monthly earnings used to...more