EBIA Weekly Archives - ERISA - Court Cases
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Results (838 articles found)
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- Insurer May Consider Relevant Nonmedical Information in Deciding Disability Claim
- From the October 22, 2009 EBIA Weekly
- The employee in this case argued that her claim for LTD benefits was improperly denied by the plan’s insurer. After her employer declined to renew her employment contract, the employee filed an LTD claim contending that she could ...
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- Court Holds That QDRO Controls Determination of Life Insurance Beneficiaries Because Welfare Plan QDROs Are Not Preempted by ERISA
- From the October 15, 2009 EBIA Weekly
- In this case, a deceased employee’s third wife and the children of his first wife all claimed a right to the employee’s group life insurance benefits. The claim of the children was based on a state ...
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- Oral Statements Allegedly Changing Plan Terms Did Not Support Claim for Fiduciary Breach
- From the October 08, 2009 EBIA Weekly
- In this case, executives of a subsidiary group that merged with its parent company sued the parent (and plan sponsor) for alleged oral misrepresentations about how their pensions would be calculated. According to the executives, they were promised that their ...
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- Health Plan May Not Sue Under ERISA for Benefits Paid to Ineligible Former Spouse (but State-Law Claims May Still Be Possible)
- From the October 08, 2009 EBIA Weekly
- In a familiar fact pattern, the employee in this case failed to notify his group health plan after he and his covered spouse divorced. In the interim, the ineligible former spouse incurred over $13,000 in medical expenses that were ...
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- Second Circuit Finds That Employer's Practice of Paying for Release Agreements Does Not Create an ERISA Plan
- From the October 08, 2009 EBIA Weekly
- In this case, a former employee argued that her employer’s ongoing practice of offering payments to certain terminating employees in exchange for signing release agreements was an ERISA plan. As background, ERISA applies only if there is a &#...
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- Former Employees Have No Claim Against Bankrupt Employer for Unpaid Medical Bills, But Can Seek Unpaid Employee Health Premiums
- From the October 01, 2009 EBIA Weekly
- Just weeks before filing for bankruptcy, the employer in this case failed to pay the employer and employee portions of insurance premiums to the insurer of its health plan, and the insurer terminated coverage. Former employees who had regular or ...
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- SPD and Denial Letters Adequately Disclosed One-Year Limitations Period
- From the September 17, 2009 EBIA Weekly
- The employee in this case sued her employer’s self-funded short-term disability plan after her claim for benefits was denied. Her lawsuit was dismissed, however, because it was filed 20 days after the plan’s one-...
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- TPA's Fiduciary Liability Was Properly Limited to the Amount of Health Plan Assets Over Which It Exercised Control
- From the September 10, 2009 EBIA Weekly
- A company edging toward bankruptcy stopped contributing to its self-funded health plan. The plan’s TPA terminated its contract with the company, and then wrote three checks (totaling approximately $10,700) on the plan’s account: one ...
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- Employee's Letter in Response to Insurer's Decision to Close Claim Was Not an Appeal
- From the September 03, 2009 EBIA Weekly
- This case addresses what constitutes an appeal under the DOL claims procedure regulations. The employee in the case stopped going to work due to a health condition and sought benefits under her employer’s long-term disability plan. According ...
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- Seventh Circuit Emphasizes Need to Assess the "Gravity" of Any Conflict of Interest in Its Latest Post-Glenn Decision
- From the August 27, 2009 EBIA Weekly
- The Seventh Circuit has decided another case addressing the effect of the Supreme Court’s Glenn decision when applying the deferential abuse of discretion standard of review in a conflict of interest situation. (For a discussion of two other ...
