News & Analysis as of

Unjust Enrichment Employee Retirement Income Security Act (ERISA)

ArentFox Schiff

Navigating Out-of-Network Claims: Key Takeaways for Providers From Surgery Center Case in New York Federal Court

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The US District Court for the Eastern District of New York in Manalapan Surgery Ctr., et al. v. 1199 SEIU National Benefit Fund, No. 23-CV-03525 (EDNY March 12, 2025), recently granted a motion to dismiss a complaint filed by...more

ArentFox Schiff

Federal Court Holds That Pathology Group States Viable Claims Against Multiplan and Cigna for Failing to Ensure In-Network Payment

ArentFox Schiff on

A federal court recently rejected arguments by MultiPlan, Inc. and Cigna Health and Life Insurance Company that they had no obligation to ensure payments at the contractually negotiated, in-network rate to Anatomic and...more

Faegre Drinker Biddle & Reath LLP

When One Door Closes, Another Opens… Maybe. Fourth Circuit Holds That Surcharge Is Not Equitable Relief Available Under ERISA But...

In an ERISA case for wrongful denial of health insurance benefits, the U.S. Court of Appeals for the Fourth Circuit addressed when a plaintiff may recover monetary relief under §§ 502(a)(1)(B) and (a)(3). The Fourth Circuit...more

Littler

Fourth Circuit Establishes New Standards for Plaintiffs Seeking Unjust Enrichment as an Equitable Remedy under ERISA

Littler on

The United States Court of Appeals recently shed light on when—and under what conditions—a plaintiff may seek a monetary recovery under § 502(a)(3) of the Employee Retirement Income Security Act (ERISA). Section 502(a)(3)...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Joins Fourth Circuit in Holding that Equitable Estoppel is Barred Where Use Would Contradict...

Hinshaw & Culbertson LLP on

In Wong v. Flynn-Kerper, 999 F.3d 1205 (9th Cir. 2021), the Ninth Circuit barred the use of equitable estoppel to challenge the purchase price of company shares under an ERISA stock ownership plan when such use would...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor – June 2021: Second Circuit Issues Statute of Limitations Ruling Favorable to Healthcare Plan Administrators

Federal law does not supply a statute of limitations for a claim seeking equitable relief under ERISA, 29 U.S.C. 1132(a)(3), and therefore federal courts borrow the limitations period of the state-law cause of action to which...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor - October 2020: Third Circuit Rules State Law Reimbursement Claims Brought by Out-of-Network Medical...

In Plastic Surgery Center, P.A. v. Aetna Life Ins. Co., 2020 U.S. App. LEXIS 22274 (July 17, 2020), the Third Circuit held that an out-of-network medical provider's state law claims against an insurer were not precluded by...more

Bowditch & Dewey

Court Allows Retired President to Pursue Claim of Contract for Lifetime Pay and Benefits Against University

Bowditch & Dewey on

On February 7, 2017, the U.S. District Court for the Eastern District of Kentucky ordered that the former President of the University of the Cumberlands, Dr. James Taylor, may proceed on his claims that the University failed...more

Eversheds Sutherland (US) LLP

Basic-Supplemental Life Insurance Plan Pricing Structure Upheld in ERISA Class Action

An employee benefit plan that includes an alleged subsidization component for its basic and supplemental options is neither prohibited by the Employee Retirement Income Security Act of 1974 (ERISA) nor a violation of the plan...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Revisiting Rochow: The Sixth Circuit Rejects Earlier $3.8 Million Equitable Award in Recent En Banc Decision

Just over a year ago, a panel decision by the Sixth Circuit Court of Appeals in Rochow v. Life Insurance Company of North America, 737 F.3d 415 made big news when the court upheld the district court’s award of $3.8 million in...more

Carlton Fields

Sixth Circuit Revisits Controversial ERISA Decision

Carlton Fields on

The Sixth Circuit Court of Appeals voted to rehear an ERISA action that awarded an unprecedented remedy for the alleged denial of long term disability benefits. The order, granting en banc rehearing, vacates a controversial...more

Proskauer - Employee Benefits & Executive...

Sixth Circuit Expands Availability of Remedies Under ERISA

The Sixth Circuit recently concluded that a disability plan participant was entitled to relief consisting of benefits under the plan and disgorgement of defendant’s profits for delaying payment. In so ruling, the Court found...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

High Court Rules Equitable Defenses Don’t Override ERISA Plan Terms

On April 16, 2013, the U.S. Supreme Court issued its decision in US Airways, Inc. v. McCutchen (No. 11–1285), deciding the issue of whether equitable defenses, such as the principle of unjust enrichment, can override the...more

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