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Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - July 2024

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This month’s Friday Five explores decisions addressing the burden of proving accidental death, policy language and “any occupation” disability, an interpleader case where the insurer was not dismissed from the case, the...more

Woodruff Sawyer

Agencies Release Proposed Regulations on Fixed Indemnity Insurance, Seek Comments on Level Funded Plans

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On July 12, 2023, the IRS, DOL and HHS (collectively, “the Agencies”) released proposed regulations that modify the conditions for hospital indemnity and other fixed indemnity insurance to be considered an “excepted benefit.”...more

Saul Ewing LLP

The Friday Five: Five Current ERISA Litigation Highlights - May 2022

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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

Saul Ewing LLP

The Friday Five: Five Current ERISA Litigation Highlights - April 2022

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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

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

Littler

“Medical Necessity” Isn’t Well-Defined Unless It Is Well-Defined

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A U.S. District Court in Connecticut recently issued an order that highlights the importance of understanding exactly what the term “medically necessary” means in an ERISA health plan....more

Seyfarth Shaw LLP

ERISA Preemption — The Courts of Appeal Continue to Rule As They Await Further Supreme Court Attempts To Define, Once and for All,...

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Synopsis: Two Courts of Appeal reach opposite results on ERISA preemption, thus continuing the judicial quest for a definitive meaning of ERISA preemption. Stay tuned for more such decisions, and yet more Supreme Court...more

Robinson+Cole ERISA Claim Defense Blog

Ninth Circuit "Interprets" Accident Plan; "Direct and Sole Cause" Doesn't Mean What It Says

In Dowdy v. Metro. Life Ins. Co., 16-15824, 2018 U.S. App. Lexis 12648 (9th Cir. May 16, 2018), the Ninth Circuit ruled that an accident plan that covers “accidental injury that is the Direct and Sole Cause of a Covered Loss”...more

Robinson+Cole ERISA Claim Defense Blog

Fifth Circuit Joins Sister Circuits by Overruling Default Deferential Standard of Review

In Ariana M. v. Humana Health Plan of Tex., 2018 U.S. App. LEXIS 5227, *5, 2018 WL 1096980 (March 1, 2018) (“Ariana M. II”), a majority of judges of the U.S. Court of Appeals for the Fifth Circuit, in an en banc decision,...more

Snell & Wilmer

Air Ambulance Services – What Does Your Plan Cover?

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Due to the increased litigation of air ambulance claims, employers may want to review their plan language to see whether their group health plan covers air ambulance services, and if so, to better understand the terms of the...more

Carlton Fields

Summary Judgment Win for Insurer in “Stable Value” Interest Rate Setting Case

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In July, MetLife obtained a win in the Northern District of Illinois when the court granted summary judgment in its favor on a claim that it had breached the duty of good faith and fair dealing in setting interest rates for a...more

Seyfarth Shaw LLP

Fifth Circuit: Discretionary Ban Does Not Mandate De Novo Review

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In Ariana M. v. Humana Health Plan of Texas, Inc., No. 16-20174 (5th Cir. Apr. 21, 2017), the Firth Circuit concluded that Texas’ ban on discretionary clauses in certain insurance policies did not require a de novo review of...more

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