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
4/4/2025
/ Administrative Remedies ,
Disability ,
Disability Benefits ,
Employee Benefits ,
ERISA Litigation ,
Fiduciary Duty ,
Insurance Claims ,
Insurance Litigation ,
Motion to Dismiss ,
Policy Exclusions ,
Preemption ,
Summary Judgment
This month’s Friday Five addresses cases covering ERISA preemption, the viability of a claim for benefits where the claimant alleges to have not received notice of a prior claim denial, an affirmance by the Circuit Court of a...more
This month’s Friday Five covers an appellate ruling on a complicated case raising both state and federal claims, an instance of procedural improprieties in the administrative review process informing the court’s substantive...more
2/10/2025
/ Compensation & Benefits ,
Denial of Benefits ,
Disability ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Fiduciary Duty ,
Insurance Claims ,
Insurance Litigation ,
Plan Administrators ,
Retirement Plan ,
Settlement
This month’s Friday Five explores recent decisions including the standard of review for ERISA benefit denials, whether structural conflict entitles a claimant to conflict-of-interest discovery, whether a “relative value...more
This month’s Friday Five covers cases relating to a claimant’s second chance when a lawyer misses a court deadline, whether certain voluntary benefits fall within a broader ERISA plan, a court deciding that an insurer was...more
This month’s Friday Five covers cases relating to: (1) whether claim administrators can recover overpayments through a breach of contract claim under state law; (2) whether claim administrators can rely solely on a claimant’s...more
4/4/2022
/ Breach of Contract ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Insurance Claims ,
Insurance Litigation ,
Medical Examinations ,
Mental Health ,
Overpayment ,
Policy Terms
This month’s Friday Five covers recent cases addressing: (1) the validity of a judgment that includes retroactive “any occupation” benefits where no administrative determination on those benefits has been made; (2) the...more