EBIA Weekly Archives - ERISA - Court Cases
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Results (852 articles found)
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- Cancer Insurance Policy Endorsed by Employer and Offered Through Cafeteria Plan Was an ERISA Plan
- From the November 24, 2009 EBIA Weekly
- An employee’s spouse sued the insurer of her cancer insurance policy in state court after it refused to pay for medical treatment she had received. The insurer removed the case to federal court, arguing that her claim was ...
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- State's Practice of Preventing Insurers From Including Discretionary Clauses in Insurance Policies Not Preempted by ERISA
- From the November 24, 2009 EBIA Weekly
- As we previously reported, an insurer challenged the Montana Insurance Commissioner’s interpretation of a state law requiring the Commissioner to disapprove insurance contracts with inconsistent, ambiguous or misleading clauses or conditions that “deceptively affect the risk” ...
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- Attorney's Letter Stating "Intention to Appeal" Was Not an Appeal
- From the November 19, 2009 EBIA Weekly
- The participant receiving long-term disability benefits in this case was notified by the insurer for her employer’s plan that benefits would be terminated because she was no longer disabled and that she had 180 days to appeal. ...
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- ERISA TPA That Is Not a Fiduciary Must Face State-Law Breach of Contract Claims by Plan Sponsor
- From the November 12, 2009 EBIA Weekly
- The employer in this case sued the former TPA of its two self-insured medical plans for claims processing errors that allegedly created millions of dollars in additional costs for the plans. Asking the court to enter judgment in its ...
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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 ...
