The Chartwell Chronicles: Permanent Disability
Physician Employment Agreements: Focus on Financial Planning
An Overview of New Jersey Workers' Compensation
An Overview of Massachusetts Workers' Compensation
Workers' Compensation Academy: Requests by Defense Counsel – A Defense Analysis of Materials Needed from Carriers and Clients for NJ Workers' Compensation Claims
An Overview of New York Workers' Compensation
Workers' Compensation Academy: Pennsylvania COVID-19 Update: Layoff or Furlough from Light Duty as a Result of COVID-19
This month’s Friday Five explores recent decisions with issues spanning physician power of attorney to preexisting exclusions and the fiduciary duty of an insurance company....more
This month’s Friday Five covers cases relating to potential impacts of COVID-19, full and fair review of the claim file, an attempt to use an insurer’s internal policy against itself, and a “second bite at the apple” by...more
This month’s Friday Five covers cases relating to discovery in ERISA benefits cases, an appellate court strictly interpreting ERISA regulatory deadlines, a district court authorizing an ERISA breach of fiduciary duty claim...more
In DeBold v. Liberty Life Assur. Co. of Bos., 2021 U.S. Dist. LEXIS 120153 (D. Mass, June 28, 2021), a district court held that an ERISA plan administrator could reduce an insured's monthly long-term disability (LTD) benefit...more
In Adkins v. Life Insurance Company of North America, 2021 U.S. Dist. LEXIS 37847 (E.D. Wash., March 1, 2021), a Washington district court blocked a plaintiff’s attempt to conduct discovery into the claim review history of an...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 Western v. Unum Life Insurance Company of America, 798 F.App'x 154, 2020 U.S. App. LEXIS 8362 (9th Cir. March 17, 2020), the Ninth Circuit affirmed Unum Life's determination that an aerospace engineer diagnosed with...more
North Carolina District Court Permits Plan’s Lawsuit Against Third Party Administrator to Continue A federal district court in North Carolina has ruled that a plan subject to the Employee Retirement Income Security Act of...more
The U.S. Supreme Court, in a unanimous decision, has ruled that a plaintiff in a lawsuit alleging a fiduciary breach under the Employee Retirement Income Security Act of 1974 (“ERISA”) did not have “actual knowledge” of the...more
In this issue: Has DOL Put Final Nail In Coffin of ‘Substantial Compliance’ Doctrine for Disability Claims? Analysis of the most recent revisions to the ERISA Claims Procedure regulations, asking whether the amendments...more
This week in our blog series on best practices in administering benefit claims, we discuss the importance of knowing and, importantly, understanding the laws governing benefit claim administration. Section 503 of ERISA...more
This month's Friday Five covers recent cases addressing: (1) the propriety of a remand for an administrative determination regarding a claimant's "any occupation" disability claim; (2) the viability of breach of fiduciary...more
This month’s Friday Five covers recent cases relating to interpretation of the term, "own occupation," the appropriate remedy for termination of benefits where the administrator’s review was limited to the "own occupation"...more
This Client Advisory highlights important developments in the law governing employee benefit plans and executive compensation over the past year. It offers insight into what these developments mean for employers and plan...more
On July 3, 2018, a District Court in Alabama upheld, on reconsideration, its initial decision to dismiss a plaintiff’s breach of fiduciary duty claim under ERISA § 502(a)(3), 29 U.S.C. § 1132(a)(3), finding that ERISA §...more
This month’s Friday Five covers cases relating to claims handling and the standard of review, as well as the proper parties to litigation. Does using the same physician for initial claim review and appeal violate ERISA...more
Despite the change in seasons, there appears to be no change in the pace of complex and class action ERISA litigation. Investments in defined contribution plans—both 401(k) and 403(b) plans—continue to be the leading target...more
Plan Sponsors Need To Fix Their Plan Errors Now! You can't wait, fix it now! For most of us, when we don't feel well, we go to the doctor. We don't wait until things get worse, we take care of things because there...more
Editor's Overview - For over two decades, federal law has required covered health plans and insurers to ensure that certain mental health benefits are in parity with offered medical/surgical benefits. The meaning of...more
Editor's Overview - As we have observed on other occasions, the ERISA class action plaintiffs' bar has, for several years now, honed in on 401(k) plan fiduciaries and their decisions to select and retain investment options...more
The stories of an employer and a long-term disability insurer and claims fiduciary for an ERISA plan, defendants in two recent cases, ring so true. In the first case, the insurer was designated as claims fiduciary for an...more
Seyfarth Synopsis: In an opinion that may result in increasingly complex ERISA benefits litigation, the Eighth Circuit has allowed a breach of fiduciary duty claim premised on alleged faulty claims handling practices to...more
In a victory for the San Bernardino County Employees’ Retirement Association (“SBCERA”) and the nineteen other county retirement systems administered under the County Employees Retirement Law of 1937 (Gov. Code, § 31450 et...more
Editor's Overview - This month, we look at the implications of the two federal district court cases from California that applied the ban on discretionary clauses typically found in ERISA plans to self-insured plans. The...more
Editor's Overview - This month, we review the Second Circuit's ruling in New York State Psychiatric Ass'n, Inc. v. UnitedHealth Grp. wherein the Second Circuit ruled that: (i) a provider association has associational...more