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Policy Exclusions Employee Benefits

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - April 2025

Saul Ewing LLP on

The April Friday Five covers cases determining futility of exhausting administrative remedies, the nuances of the pre-existing condition exclusion, ERISA preemption, and genuine issue of material fact over an employee’s...more

Carlton Fields

California Appellate Court Agrees Marijuana Delivery Driver’s Accident Not Covered Under Personal Auto Policy

Carlton Fields on

A California Court of Appeals decision brought one auto policyholder decidedly down from “cloud nine” in Murphy v. AAA Auto Insurance of Southern California, which found no coverage over a cannabis delivery service employee’s...more

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

Fisher Phillips on

A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - March 2024

The March Monthly Minute digs into an Ohio district court ruling that rejected application of a medical plan exclusion, missing participant guidance and related audit concerns, and responses to the Change Healthcare...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor – June 2021: Health Plan May Not Exclude Specific Autism Treatments

The extent to which a health plan may exclude coverage for mental health treatment modalities has become an active area in ERISA litigation. In Doe v. United Behavioral Health, 2021 U.S. Dist. LEXIS 43146 (N.D. Cal. March 5,...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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