Employee Benefits Litigation

You already know that ERISA regulations require the plan administrator to render a decision on an administrative appeal within 45 days.

If more time is needed, the ERISA regulations require that the plan administrator notify the beneficiary before the 45 day period expires that more time is needed due to special circumstances.

BUT what should

What happens when an independent, unsolicited source provides evidence that a disability claimant may be committing fraud?  Can you consider emails hacked from a computer? What must the claim administrator do to evaluate the source of the evidence?

Here’s a fun new case to read (even if you don’t care about the issue presented). Truitt

The U.S. Supreme Court yesterday strengthened the ability of employer health insurance plans to recoup payments for medical expenses paid for an injured plan participant who later sues to recover damages from a third party.

The case is US Airways v. McCutchen, U.S. Supreme Court, No. 11-1285.


This decision helps resolve a conflict