You already know about the contractual limitations provision in disability policies. The provision works to bar untimely lawsuits.
So, it is no surprise that the interpretation/application of these provisions has been the subject of significant litigation.
Here’s a short new case concluding the contractual limitations provision was “unambiguous,” and dismissing the claim as untimely. Kuber …
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.
Does telling a claimant that you “will be happy to reconsider the claim” waive a contractual limitations provision? No.
Here is a great new case that highlights virtually every argument that could be used to trump (unsuccessfully) a statute of limitations or contractual limitations provision. Engleson v. Unum Life Insurance Company of America, __ F.3d…
