Court Endorses Disability Claimant’s Right to Review and Respond to New Information Prior Reaching ERISA Benefit Determination

I recently wrote an article for the ABA’s Torts Insurance Practice Section (“TIPS”) Health, Disability, and Life Insurance Committee summer newsletter, which was published on Monday, July 31, 2017. In the article, I discussed how the Department of Labor’s new ERSIA disability claims regulations, which are effective for claims arising on or after January 1, 2018, can potentially have a meaningful impact on ERISA claims arising before that date. Well, as fate would have it, that same day the United States District Court for the Northern District of Illinois issued an opinion agreeing with that very argument in a case in which I served as co-counsel with my friend, colleague, and lead counsel Michael Bartolic of Roberts Bartolic LLP.

Fourth Circuit Rules in Favor of Employer in Retiree Health Benefits Case

In a blow to retirees, the United States Court of Appeals for the Fourth Circuit recently affirmed a decision granting summary judgment to an employer in a case involving changes to a retiree health benefits plan. See Barton v. Constellium Rolled Products-Ravenswood, LLC, Case No. 16-1103, 2017 U.S. App. LEXIS 5087, __ F.3d __ (4th Cir. March 22, 2017).

A Life Insurance Fiduciary Breach Case Gets Set for Trial

Today’s blog post brings us another life insurance case in which an insurer and an employer were alleged to have breached their fiduciary duty to a plan participant and his beneficiary. That case, Keith v. Metro. Life Ins. Co., et al., Case No. H-15-1030, 2017 U.S. Dist. LEXIS 37263 (S.D. Tex. March 15, 2017), is now headed to trial because the Court denied the parties’ cross motions for summary judgment yesterday.

Court Declines to Remand Case Involving an Alleged Church Plan and Finds ERISA Controls Instead

Although the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”), regulates nearly all non-governmental employer sponsored benefit plans, a notable exception exists for so-called “church plans.” Last week, while I was at a conference where the church plan exemption was discussed at length, the United States District Court for the Central District of California issued a decision in Durham v. Prudential Ins. Co. of Am., Case No. 2:16-cv-08202-ODW(KSx), 2017 U.S. Dist. LEXIS 19402 (C.D. Cal. February 10, 2017). In Durham, the Court found that a long-term disability (“LTD”) benefit plan Loyola Marymount University (“LMU”) sponsored for the benefit of its employees was not a church plan. The Court found ERISA applied to the claim instead.

The Impact of a Layoff on a Long-Term Disability Claim

Last week I was fortunate to attend the American Bar Association’s Torts Insurance Practice Section (“TIPS”) Mid-Winter Symposium on Insurance and Employee Benefits. During the conference a speaker discussed the impact a lay off can have on a disabled employee’s long-term disability claim. Well, the speaker’s timing was impeccable because The United States District Court for the District of Arizona issued a decision on that very topic yesterday.

D.C. Circuit Affirms Dismissal of Stock Drop Lawsuit

Happy New Year! Following up on my last two posts that dealt with individual ERISA breach of fiduciary duty claims, this morning’s post deals with the dismissal of a potential breach of fiduciary duty class action. On December 30, 2016, the U.S. Court of Appeals for the District of Columbia Circuit affirmed the dismissal of a “stock drop” lawsuit filed by a former employee of J.C. Penney.

Another ERISA Breach of Fiduciary Duty Claim Based on a Material Misrepresentation Survives a Motion to Dismiss

Following up on my recent blog post about an interesting breach of fiduciary case in Louisiana, on December 29, 2016, the U.S. District Court for the District of Maryland partially denied a motion to dismiss seeking the dismissal of an ERISA breach of fiduciary duty claim brought by a plan participant as result of a material misrepresentation.

The Beginning of an Interesting Post-Amara ERISA Case in Louisiana

This morning, I came across a brief and interesting decision issued by the United States District Court for the Eastern District of Louisiana addressing the scope of equitable remedies available to participants in ERISA cases. In Lauga v. Applied-Cleveland Holdings, Case No. 16-14022 SECTION: "H"(3), 2016 U.S. Dist. LEXIS 173464 (E.D. La. December 15, 2016), the Court denied a motion to dismiss filed by MetLife in which it sought to apply a suicide exclusion in a claim seeking life insurance benefits. The reason for the Court’s decision may make this a case to watch if it proceeds through litigation.

Deadlines for Remanded Disability Claim Reviews: A Recent Decision Says 45 to 90 Days

Occasionally courts will remand a disability claim back to the plan’s claim administrator (often an insurance company) for further consideration if it finds that the claimant has been denied a full and fair review of his or her claim. The Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001, et seq. (“ERISA”) and its claims regulations are silent as to how long the claim fiduciary has to consider the remanded claim before making another claim determination. A recent decision from the United States District Court for the District of Oregon held that the remanded claim should be treated like any other administrative appeal of a disability claim determination and ruled upon within 45 to 90 days, depending on the circumstances.

Chronic Pain: A New Appreciation

Today, I have a new-found appreciation of pain and what individuals with chronic pain conditions must experience. I am very fortunate that I have spent most of my life pain-free. Sure, I have had injuries, some surgery, and moments of pain, but I have never experienced truly debilitating or chronic pain. That is, until this morning.

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