Happy New Year, ERISA Watchers! We were scheduled to be off this week but with good news on the ERISA remedies front, I could not resist. This week’s notable decision, Laurent v. PricewaterhouseCoopers LLP, No. 18-487-CV, __F.3d__, 2019 WL 7042414 (2d Cir. Dec. 23, 2019), is more fruit from Amara’s labor. In a
Eighth Circuit Affirms Dismissal of Complaint Seeking Continued Long-Term Disability Benefits Based on Physical Disability
This week’s notable decision is Miller v. Hartford Life & Accident Ins. Co., No. 19-1096, __F.3d__, 2019 WL 6834049 (8th Cir. Dec. 16, 2019), a case highlighting the difficulty of establishing a “physical” disability claim when the symptoms are psychiatric in nature. Plaintiff Diane Miller filed an action against Hartford Life & Accident Insurance Company (“Hartford”) when it terminated her claim for long term disability benefits based on the exhaustion of benefits owed due to a mental illness, and the lack of evidence of a disabling physical condition which would justify further benefit payments. The district court granted Hartford’s motion to dismiss, finding that Hartford’s decision was supported by substantial evidence. The Eighth Circuit Court of Appeals affirmed.
Plaintiff argued that the dismissal of her complaint was erroneous for several reasons, including that there was insufficient evidence of improvement in her condition and that Hartford failed to consider the potential medications side effects and the future risk of additional psychotic episodes. The court explained that these arguments fail to consider the primary reason for Hartford’s benefit termination: the fact that the record did not support a finding of a physical disability.
Continue Reading Eighth Circuit Affirms Dismissal of Complaint Seeking Continued Long-Term Disability Benefits Based on Physical Disability
District Court Finds Breach of Fiduciary Duty Claim Adequately Plead Where Claimant Was Not Given Life Insurance Conversion Options
Ho ho ho, merry holidays. This week Kantor & Kantor helped bring justice to the nice and coal to the naughty as we take a closer look at why a district court in Harris v. Life Ins. Co. of N. Am., No. 19-cv-04594, __ F.Supp.3d __, 2019 WL 6769660 (N.D. Cal. Dec. 11, 2019), reminded an ERISA fiduciary that failing to do what it said it would do may have equitable consequences.
Plaintiff’s husband received life insurance coverage through an ERISA plan sponsored by his employer, BDO USA, LLP, and insured by Life Insurance Company of North America (“LINA”). Both BDO and LINA were ERISA fiduciaries with respect to the life insurance plan. Plaintiff’s husband stopped working due to terminal cancer in July 2015 and LINA approved his disability benefits. In this situation, under the terms of the life plan, coverage continued for another twelve months – through July of 2016 – after which coverage continued if it was converted or ported.
Continue Reading District Court Finds Breach of Fiduciary Duty Claim Adequately Plead Where Claimant Was Not Given Life Insurance Conversion Options