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Employee Retirement Income Security Act (ERISA) Disability Insurance

Hall Benefits Law

Employer Involvement Rendered Disability Insurance Plan Subject to ERISA, Despite Lack of Intent

Hall Benefits Law on

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

Carlton Fields

Ringmaster’s Review: Fall 2023 Litigation on Parade

Carlton Fields on

In Ross v. Venerable Insurance & Annuity Co., a Missouri appellate court reversed judgment in favor of the named beneficiary of a flexible premium deferred annuity contract. Following the annuitant’s death, the beneficiary...more

Littler

Seventh Circuit Case Confirms that “Full and Fair Review” of Disability Claims Requires Disclosure of New Evidence Before Denying...

Littler on

A recent federal appeals court case clarifies that, under ERISA, the regulations governing disability plans’ claims review procedures apply to claims that predate the 2018 changes to the regulations. The decision also serves...more

Robinson+Cole ERISA Claim Defense Blog

U.S. Supreme Court Denies Review Of Significant Second Circuit Ruling On The Scope Of California’s Anti-Discretion Statute And The...

The U.S. Supreme Court recently declined to review a significant decision of the Second Circuit which (1) clarified the scope of California’s statutory ban on discretionary clauses in life and disability insurance contracts,...more

Genova Burns LLC

How to Comply with ERISA’s Prohibited Transactions Requirements For Group Benefit Plans

Genova Burns LLC on

The Employee Retirement Income Security Act of 1974 (“ERISA”), the principal federal law which regulates the benefit plans marketed to employers in this country, imposes specific requirements on most employer-sponsored...more

Manatt, Phelps & Phillips, LLP

CA Approves New Parity Law Expanding Coverage Obligations for Mental Health and SUD Treatment

On September 25, 2020, Governor Newsom signed Senate Bill 855 into law. SB 855 fundamentally alters California’s regulation of mental health and substance use disorder (MH/SUD) treatment, and it applies to all California...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Rules Coverage under ERISA Disability Plan Excluded Due to Underlying Medical Condition

In Estate of Maurice v. Life Ins. Co. of N. Am., 792 Fed. Appx. 499 (9th Cir. Cal. Feb. 5, 2020), the Ninth Circuit held that coverage was excluded under an ERISA-governed disability plan ("Plan"), because the evidence in the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Reverses Award of Attorneys' Fees

In Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., 29 U.S. App. LEXIS 36542 (N.D. Cal. Dec. 10, 2019), the Ninth Circuit reversed a district court's award of attorneys' fees to an ERISA claimant as...more

Verrill

New Disability Claims Procedures Affect Retirement Plans and Deferred Compensation Plans Too

Verrill on

Much has been written about the Department of Labor’s final rule regarding disability benefit claims procedures (the “Final Rule”), which took effect on April 2, 2018. And by now, most employers – and all disability insurance...more

Snell & Wilmer

New Disability Claims Regulations Take Effect for All Plans April 1, 2018

Snell & Wilmer on

As noted in our previous blog post, The New Disability Claims Regulations: They Don’t Only Apply to Disability Plans, the Department of Labor (“DOL”) issued regulations that revise the ERISA claims procedure regulations for...more

Proskauer - Employee Benefits & Executive...

District Court Applies Texas Ban on Discretionary Clauses in Insurance Contracts

A federal district court in Louisiana upheld a Texas state law prohibiting insurers from granting themselves discretion to interpret benefit plans when deciding benefit claims. These so-called “discretionary clauses” are...more

WilmerHale

My Supreme Court Debut: A Birthday I’ll Never Forget

WilmerHale on

As the end of the year draws near, all eyes are turning to the U.S. Supreme Court and the decisions it will issue during its October 2017 term. In this Expert Analysis, Catherine Carroll reflects on her very first time...more

Poyner Spruill LLP

Time to Prepare for the End of the Year - Part Three

Poyner Spruill LLP on

The year-end is rapidly approaching! To avoid costly penalties from inadvertent errors in the year-end rush, plan sponsors should begin talking with their service providers now about what must be done by year-end. Our first...more

Proskauer - Employee Benefits & Executive...

Disability Claims Procedures Should be Updated for New Regulations

As open enrollment approaches for many benefit plans, employers and plans sponsors should check to make sure their claims procedures for disability claims are consistent with regulations that become effective for plan years...more

McDermott Will & Emery

The Future of Discretionary Clauses in California Life and Disability Insurance Agreements

McDermott Will & Emery on

On May 11, 2017, the United States Court of Appeals for the Ninth Circuit reversed a district court ruling, and upheld a California law that invalidates a plan provision that assigns the final determination on benefit payout...more

Seyfarth Shaw LLP

Grounding Deferential Review in California – No Preemption for Discretionary Clause Ban

Seyfarth Shaw LLP on

Seyfarth Synopsis: In a decision with wide ranging implications, the Ninth Circuit has ruled that a discretionary clause in an employer drafted plan document is subject to, and invalidated by, California’s insurance...more

Jackson Lewis P.C.

The New ERISA Claims and Appeals Regulations for Disability Benefits

Jackson Lewis P.C. on

The Employee Benefits Security Administration of the U.S. Department of Labor recently published final regulations governing the ERISA claims and appeals process that will apply to all claims for disability benefits filed on...more

McDermott Will & Emery

Seventh Circuit Finds that State Insurance Law Applies, Resulting in De Novo Review of Benefit Claim

McDermott Will & Emery on

On September 4, 2015, the U.S. Court of Appeals for the Seventh Circuit ruled in Fontaine v. Metropolitan Life Insurance Company that the Employee Retirement Income Security Act of 1974, as amended (ERISA), does not preempt...more

Goodwin

En Banc Sixth Circuit Rules Against Disgorgement Remedy in Benefits Case

Goodwin on

In Rochow v. Life Insurance Company of North America, No. 12-2074 (6th Cir. March 5, 2015), the U.S. Court of Appeals for the Sixth Circuit, sitting en banc, ruled that an insurance company that wrongfully denied benefits to...more

Proskauer - Employee Benefits & Executive...

Ninth Circuit Rules That Harmless Procedural Violation Does Not Alter Standard of Review

The Ninth Circuit held that a plan administrator’s failure to render a decision on a long-term disability benefits claim within the period mandated by the plan and ERISA did not alter the standard of review that the court...more

Williams Mullen

Court Holds That Physician’s State Law Claim For Disability Benefits Is Preempted by ERISA: Hershan v. Unum Group Corporation

Williams Mullen on

A federal court has held that a radiologist’s state law contract claim for certain disability insurance benefits arose under a welfare benefit plan governed by ERISA and was therefore preempted by ERISA. In Hershan v. Unum...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - October 2014

Proskauer Rose LLP on

Editor's Overview - The first article in this month's newsletter focuses on whether specific language in ERISA employer-provided disability insurance plans confer discretionary authority to plan administrators to...more

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

What Happens When The Limitations Provision in the Plan As Applied Creates An Impossible Accrual Date?

Approximately six months ago, the Supreme Court of the United States, in Heimeshoff v. Hartford Life & Accident Insurance Co., 134 S. Ct. 604 (2013), addressed whether an employee benefit plan covered by the Employee...more

Womble Bond Dickinson

Employee Benefit Plan is Governmental Plan, Even Though Employees are Not, says District Court in 11th Circuit.

Womble Bond Dickinson on

It is a deceptively simple statement: Governmental employee benefit plans are exempt from ERISA. 29 U.S.C. § 1003(b)(1). But what about an employee benefit plan of an entity affiliated with a governmental entity, but whose...more

Bradley Arant Boult Cummings LLP

After Heimeshoff: Applying An ERISA Plan’s Contractual Limitation of Actions Provision

In Heimeshoff v. Hartford Life & Acc. Ins. Co., 134 S.Ct. 604 (2013), the Supreme Court held that an ERISA plan’s contractual limitations period can be enforced, so long as the claimant has a reasonable time after exhausting...more

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