You know that claimants have the burden to establish eligibility for ERISA-governed disability benefits.
Sometimes gaps in coverage can occur when, for example, a claimant alleges disability while using accrued vacation. These gaps can result in denial of a disability claim.
Here’s the case of Cheney v. Standard Insurance, __ F.3d __, (7th Cir.
Who can challenge an ERISA benefit denial? Does a physician have standing to challenge the denial of a patient’s coverage? It depends.
Here’s the case of American Psychiatric Association v. Anthem Health Plans, 821 F. 3d 352 (2nd Cir. 2016)(Physicians and physician associations lacked standing to sue health plans under ERISA.)
Is it wrong to take an offset for Social Security benefits received by the children of a long term disability claimant? No, says a new decision.
And… just because you reinstate benefits does not mean you have to provide Pannebecker payments…
Here’s the case of Jones v. Life Insurance of North America,
These Section 502(c) penalty claims seem to be added to most every ERISA lawsuit…
Does a claimant have to prove “actual injury” to win ERISA Section 502(c) penalty claims? MAYBE. Here’s why:
As you know, if a plan administrator fails to provide plan-related documents within 30 days of a written request, then ERISA section
Attorney fees in ERISA cases continue to be a challenge.
What happens when both sides can claim wins during a case?
What is a reasonable hourly rate for Plaintiff’s attorneys?
Here’s the case of Barboza v. California Association of Professional Firefighters, 2016 WL 3125996, (E.D. Ca. June 3, 2016).(This case involved years of litigation
Lane Powell attorney Mike Baylous writes an excellent summary here on big changes to ERISA in the 9th Circuit.
Remember that old argument that equitable claims should be dismissed because they are duplicative?
Not so anymore in the 9th Circuit (or the 8th Circuit for that matter).
Here is the case of Moyle
For many reasons, some of the toughest cases to litigate involve the application of the suicide exclusion.
There is a growing body of evidence challenging suicide exclusion determinations.
Here is the recent case of Collins v. Unum Life Insurance Co., 2016 WL 2753862, __ F.Supp.3d __ (May 6, 2016). This case walks you through
You know that most ERISA disability plans contain a 24-month limitation related to mental/nervous disabilities.
But what happens when the claimant alleges the mental illness is “organically caused”? Is that enough to justify benefits beyond the 24-month period?
Not in this case…
Here’s the case of McAlister v. Liberty Life Assur. Co. of Boston
You know that many Plans have forum selection clauses. Are they enforceable? YES
When a Plan participant claims they “did not know of a plan amendment,” how do you prove the Participant received notice of the amendment? A new case explains.
Here’s the case of Malagoli v. AXA Equitable Life Insurance Company, __
Must denial letters inform the claimant, seeking ERISA-governed benefits, about the contractual limitations provision?
A recent court trend, like with the First, Third and Sixth Circuits, requires denial letters to inform the claimant of the Plan’s contractual limitations provision. See, e.g., Santana- Díaz v. Metropolitan Life Insurance Co., No. 15-1273, 1st Cir.