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Standard of Review Employee Benefits

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - August 2025

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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

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

Jackson Lewis P.C.

Eighth Circuit: Procedural Irregularity Not a “Gateway” to De Novo Review of Administrator’s Decision to Deny Benefits

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In McIntyre v. Reliance Standard Life Insurance Company, 972 F.3d 955 (8th Cir. 2020), the United States Court of Appeals for the Eighth Circuit clarified the standard of review to apply where there has been a denial of...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor – June 2021: Sixth Circuit Upholds Denial of Accidental Death Benefits Under "Substantial Factor" Test

In Duncan v. Minnesota Life Ins. Co., 2021 U.S. App. LEXIS 4069 (6th Cir. Feb. 10, 2021), the Sixth Circuit held that an insurer properly denied accidental death benefits on the grounds that a patient's leukemia caused the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Tenth Circuit Finds District Court Applied Wrong Standard of Review in Evaluating Plan...

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In Lyn M. v. Premera Blue Cross, 2020 U.S. App. LEXIS 23395 (10th Cir. July 24, 2020), the Tenth Circuit held that a district court had applied the wrong standard of review and incorrectly evaluated an ERISA plan...more

Seyfarth Shaw LLP

The 10th Circuit’s New Interpretation of What is Mandated under ERISA’s Notice Requirements May have Far Reaching Effects On Plan...

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Seyfarth Synopsis: A recent 10th Circuit decision holding that in order for the abuse of discretion standard to apply in litigation the claims administrator must provide participants with actual notice of discretionary...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: First Circuit Holds Decision to Deny Accidental Death and Dismemberment Benefits Not an Abuse of Discretion

In Arruda v. Zurich Am. Ins. Co., 951 F.3d 12, 13 (1st Cir. 2020), the First Circuit held that a claims administrator's decision to deny accidental death and dismemberment benefits was not an abuse of discretion where...more

Proskauer - Employee Benefits & Executive...

Choice-of-Law Plan Provision Enforced As A Matter of Federal Common Law

The Tenth Circuit recently concluded that, as a matter of federal common law, a choice-of-law provision in a long-term disability insurance policy, which was part of the plaintiff’s employer’s ERISA plan, must be enforced...more

Proskauer - Employee Benefits & Executive...

Best Practices in Administering Benefit Claims #8 – Facing Litigation of Benefit Claims

Up to now, our blog series has focused on best practices for implementing a plan’s claims and appeals procedure. We shift gears this week to see how following these best practices pays dividends if a participant’s (or...more

Littler

Full and Fair Review Requirement under ERISA Gets a Full and Fair Review

Littler on

On July 15, 2019, the U.S. Court of Appeals for the Tenth Circuit touched on the new regulations governing what constitutes a “full and fair review” of a claim for benefits under the Employee Retirement Income Security Act....more

Proskauer - Employee Benefits & Executive...

Tenth Circuit Upholds Denial of Residential Mental Health Treatment

The Tenth Circuit upheld a claims administrator’s decision denying a claim for residential mental health treatment as not medically necessary...more

Proskauer Rose LLP

ERISA Newsletter - First Quarter 2019

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Editor's Overview - We often talk about the importance of evaluating whether there are any procedural obstacles to plaintiffs pursuing their ERISA claims, particularly in complex, class actions where it may not be...more

Saul Ewing LLP

The Friday Five: Five Current ERISA Litigation Highlights – February 2019

Saul Ewing LLP on

This month's Friday Five brings a quartet of court of appeals decisions: a pair from the Ninth Circuit relating to standard of review, an Eighth Circuit decision upholding a mental illness limitation, and a Sixth Circuit case...more

Spilman Thomas & Battle, PLLC

The Need for Clarity: Standard of Review

In Griffin v. Hartford Life & Acc. Ins. Co., 898 F.3d 371 (4th Cir. 2018), the Fourth Circuit addressed the issue of whether a related company of an entity that enjoyed the abuse of discretion standard also was entitled to...more

Spilman Thomas & Battle, PLLC

ERISA & Employee Benefits Alert: October 2018

Welcome to the first edition of ERISA & Employee Benefits Alert. Our ERISA and Managed Care Group will be providing curated insights and news concerning notable ERISA and managed care issues that highlight current or emerging...more

Holland & Knight LLP

Eighth Circuit Upholds ESOP Administrator's Decision on Death Benefit Claim

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• The U.S. Court of Appeals for the Eighth Circuit has affirmed a U.S. District Court's application of deferential standard to the review of an employee stock ownership plan (ESOP) administrator's decision based on broad...more

Proskauer - Employee Benefits & Executive...

Second Circuit Requires Reevaluation of ERISA Attorney Fee Judgment

The Second Circuit determined that a district court erred when it denied an attorney fee award to an ERISA plaintiff who had sought benefits from a plan. In so ruling, the Second Circuit first concluded the district court...more

Kilpatrick

A Recent 5th Circuit ERISA Decision is Not as Far Reaching as it Appears

Kilpatrick on

To reduce the cost of maintaining an ERISA plan and reduce the expense of ERISA litigation, it is helpful to have courts both apply a deferential standard of review and limit the review to the administrative record. If an...more

Seyfarth Shaw LLP

Seventh Circuit Says: Clear Error Standard Applies To Court Review Of Withdrawal Liability Arbitrator’s CBA Interpretation

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Seyfarth Synopsis: The Seventh Circuit has now applied a clear error standard of review to a withdrawal liability arbitrator’s interpretation of a collective bargaining agreement, thus enhancing the role of the arbitrator in...more

Burr & Forman

Court upholds South Carolina company's benefits plan decision

Burr & Forman on

One of the most important components of the employment relationship is the benefits package an employer is able to offer its employees. Employee benefits have to make business sense for the employer because there’s always a...more

Littler

With the Election (Mercifully) Behind Us, What Will a Trump Administration Mean for Employers?

Littler on

The 2016 Presidential election was arguably the most contentious, unpredictable, and politically polarizing race in this nation's history. The contours of the electoral map changed by the hour in the days leading up to...more

McDermott Will & Schulte

Second Circuit Applies Stricter Rules for a Plan Administrator’s Noncompliance with Benefit Claims Regulations

In Depth - On April 12, 2016, the US Court of Appeals for the Second Circuit in Halo v. Yale Health Plan, 2016 WL 1426291 (2d Cir. Apr. 12, 2016), addressed various issues that could arise during a plan administrator’s...more

Stinson - Benefits Notes Blog

Are Top Hat Plans Entitled to a Discretionary Standard of Review?

Many years ago the Supreme Court decided that qualified retirement plans that gave their fiduciaries discretion to determine plan benefits were entitled to have their decisions, reviewed by a court under a generous “abuse of...more

Winstead PC

Fifth Circuit Denies Deferential Review for Fiduciary Actions

Winstead PC on

Many employee benefit professionals are aware of the deferential standard of review provided to plan fiduciaries in accordance with the 1989 United States Supreme Court ruling in Firestone Tire & Rubber Co. v. Bruch. That...more

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