Within days of one another, the U.S. Court of Appeals for the Ninth and Second Circuits ruled—on issues of first impression for both—that ERISA expressly preempts state law breach of contract and promissory estoppel claims...more
6/21/2024
/ Breach of Contract ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Employer Group Health Plans ,
Health Insurance ,
Insurance Contracts ,
Out of Network Provider ,
Plan Administrators ,
Preemption ,
Promissory Estoppel ,
Reimbursements
In Hawkins v. Cintas Corp., No. 21-3156, __ F.4th __, 2022 WL 1236954 (6th Cir. Apr. 27, 2022), the U.S. Court of Appeals for the Sixth Circuit ruled that an arbitration clause contained in certain individual employment...more
5/10/2022
/ Arbitration ,
Arbitration Agreements ,
Breach of Duty ,
Duty of Loyalty ,
Duty of Prudence ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
ERISA Litigation ,
Fiduciary Duty ,
Investment Management ,
Motion to Compel ,
Putative Class Actions ,
Retirement Plan
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
3/3/2022
/ Administrative Review ,
Claim Procedures ,
Commerce Clause ,
Denial of Certiorari ,
Disability Insurance ,
Discretionary Functions ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
First Impression ,
Life Insurance ,
Policy Terms ,
SCOTUS
In Ruderman v. Liberty Mut. Grp., Inc., No. 21-817, 2022 WL 244086 (2d Cir. Jan. 27, 2022), the U.S. Court of Appeals for the Second Circuit ruled that reclassification of a claimant’s disability from one that is...more
Plaintiffs seeking recovery of group disability benefits under ERISA-governed plans routinely argue that claim fiduciaries failed to adequately consider and/or account for decisions by the Social Security Administration...more
In 2010, Chief Justice John Roberts observed that that ERISA is “an enormously complex and detailed statute.” Conkright v. Frommert, 559 U.S. 506, 509 (2010)....more
In Hansen v. Group Health Cooperative, 2018 U.S. App. LEXIS 25033, (9th Cir. Sep. 4, 2018), two psychotherapists (“Providers”) sued Group Health Cooperative (“GHC”) in Washington state court, alleging GHC engaged in unfair...more
Significant changes to the Department of Labor’s (“DOL”) rules regulating disability claims procedures are now in force. These new rules apply to claims filed on or after April 1, 2018....more
The U.S. Court of Appeals for the Second Circuit has ruled that New York’s anti-subrogation statute, N.Y. Gen. Oblig. Law § 5-335(a), applies both to “offsets” for prospective benefit payments and to reimbursements for prior...more
11/3/2017
/ Aetna ,
Choice-of-Law ,
Disability Benefits ,
Employee Benefits ,
Employee Retirement Income Security Act (ERISA) ,
Insurance Industry ,
Insurance Litigation ,
Jurisdiction ,
Petition for Writ of Certiorari ,
Preemption ,
Settlement ,
Subrogation ,
Workplace Injury