No case of the week this week as we make it through the end of winter doldrums. But keep reading for many interesting ERISA developments.
Continue Reading Your ERISA Watch – Week of March 9, 2022
Fourth Circuit Rules That Administrator’s Failure to Respond to Claimant’s Request for Information Demonstrated Futility of Appealing
Wilson v. UnitedHealthcare Ins. Co., No. 20-2044, 2022 WL 552028 (4th Cir. Feb. 24, 2022) (Before Circuit Judges Agee, Thacker, and Quattlebaum).
This week’s notable case once again demonstrates how health insurance claims are confusing and littered with procedural and substantive land mines. This case involves one person who received treatment at one facility during one continuous period of time, yet the Fourth Circuit’s analysis of the related insurance claims submitted for that treatment has resulted in three different holdings: one regarding medical necessity, one regarding the administrator’s breach of fiduciary duty, and one regarding the claimant’s failure to properly follow procedural rules.
Continue Reading Fourth Circuit Rules That Administrator’s Failure to Respond to Claimant’s Request for Information Demonstrated Futility of Appealing