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Thompson v. Oracle Corp., No. 4:21-cv-00026-YGR, 2021 WL 5865519 (N.D. Cal. Dec. 10, 2021) (Judge Yvonne Gonzalez Rogers). 

When Elisa Thompson went to work for Sun Microsystems, she specifically negotiated a job offer that included a guarantee of lifetime disability benefits because she was concerned about the possible return of a childhood disability. When Oracle Corporation, which had acquired Sun Microsystems, reneged on this promise following an amendment to the company’s disability policy, Ms. Thompson filed suit asserting claims under state law – for breach of contract, promissory estoppel, fraudulent and negligent misrepresentation and elder abuse – and under ERISA for benefits and fiduciary breach.  Oracle moved to dismiss three of the state-law claims and both of the ERISA claims.
Continue Reading State-Law Claims for Lifetime Disability Benefits Survive While ERISA Claims Are Dismissed

ERISA Watch has two highlights this week: one is a win by a disabled plan participant, represented by Kantor & Kantor, at the Fourth Circuit, and the other is an examination of Monday’s argument at the Supreme Court in Hughes v. Northwestern.

Shupe v. Hartford Life & Accident Ins. Co., No. 19-1854, __ F.4th __, 2021 WL 5774728 (4th Cir. Dec. 7, 2021) (Before Circuit Judges Wilkinson, Agee, and Floyd).

Robert Shupe was an Executive Sous Chef for the Hyatt Corporation in San Diego. In 2003 he began experiencing symptoms of osteomyelitis, an infection in his spinal cord. He sought treatment, but nothing was effective and in 2004 he was forced to stop working. He submitted a claim to Hartford, the insurer of Hyatt’s long-term disability benefit plan, which approved his claim.
Continue Reading A Victory for a Disabled Plan Participant at the Fourth Circuit, and a Summary of the Supreme Court Argument in Hughes v. Northwestern

Jette v. United of Omaha Life Insurance Co., No. 20-1719, __ F.4th __, 2021 WL 5231971 (1st Cir. Nov. 10, 2021) (Before Circuit Judges Howard and Thompson, and District Court Judge Raul Arias-Marxuach).

ERISA, as our readers know, requires that plan fiduciaries employ a “full and fair” claims procedure for reviewing benefit claims. But courts have grappled with what exactly this entails and specifically, whether this requires that a plan participant or beneficiary making a claim for benefits be given an opportunity to review and respond to medical reports before they are relied upon by the claims administrator to deny the claim. The answer from the First Circuit is a resounding “yes,” regardless of what version of the Department of Labor’s claims regulation applies.
Continue Reading First Circuit Holds That Full and Fair Review Requires Timely Disclosure of All Relevant Documents