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This week’s notable decision is a short and sweet read in the matter of Reed v. KRON/IBEW Local 45 Pension Plan, No. 17-17176, __F.App’x__, 2019 WL 2145652 (9th Cir. May 16, 2019), where the Ninth Circuit reversed the district court’s decision finding that it was not an abuse of discretion for Defendant to deny survivor-spousal benefits to a same-sex domestic partner.

By way of background, Plaintiff David Reed and Donald Lee Gardner, an employee of KRON-TV, were registered as domestic partners in California on 2004.  Mr. Gardner retired in 2009 and elected a single-life annuity pension under the KRON/IBEW Local 45 Pension Plan (the “Plan”).  Reed claimed that KRON-TV’s HR department never mentioned the availability of a joint-and-survivor form of benefit although they knew he and Gardner were registered domestic partners.  In May 2014, Reed and Gardner got married and then Gardner passed away five days later.  Reed submitted a claim for a survivor benefit to the KRON/IBEW Local 45 Pension Plan (the “Committee”), which it denied.
Continue Reading Ninth Circuit Holds that Same-Sex Domestic Partner Is Entitled to Joint-and-Survivor Pension Benefits

Happy Mother’s Day!  This is the one day a year where I can say “But it’s Mother’s Day!” to get my kids to comply without (much) protest.  They also did give me a few hours of peace and quiet today so I could wrap up today’s notable decision.  This week I want to highlight a district court decision, Khan v. Provident Life & Accident Ins. Co., 2019 WL 1970516 (W.D.N.Y. May 3, 2019), that contains a treasure trove of findings for those of us who represent claimants in long-term disability claims.  

The court’s decision comes from its review of the Magistrate Judge’s Report and Recommendation (R&R) denying the parties’ cross-motions for judgment and recommending a plenary bench trial before the district court.  The court rejected and accepted in part the R&R and granted Plaintiff’s Motion for Summary Judgment.  On de novo review of Provident’s decision, the court found that Plaintiff Khan, who became disabled from his career as a hospital neurologist at the age of 49 due to relapsing polychondritis and polyarthralgias, was entitled to Own Occupation and Any Occupation benefits, denying Provident the opportunity on a remand to consider the Any Occupation claim in the first instance.  
Continue Reading Court Denies Insurance Company Chance to Decide “Any Occupation” Disability Claim for Disabled Neurologist; Orders Payment of Benefits

Good morning, ERISA Watchers!  This week’s notable decision is Tran v. Minnesota Life Ins. Co., No. 18-1723, __F.3d__, 2019 WL 1894769 (7th Cir. Apr. 29, 2019). The Seventh Circuit reversed the district court’s ruling finding that the insured’s death from autoerotic asphyxiation was an accidental death payable under his life insurance policy.  The Seventh Circuit held that a reasonable person would interpret the insured’s death from autoerotic asphyxiation to be death due to an “intentionally self-inflicted injury,” which is excluded from the life insurance policy.

If in addition to being unable to say “autoerotic asphyxiation” five times fast you also don’t know what it refers to, the Seventh Circuit noted its definition as “a sexual practice by which a person purposefully restricts blood flow to the brain to induce a feeling of euphoria. ‘Asphyxiophilia’ as defined in the DSM-5 is a subset of sexual masochism disorder, by which an ‘individual engages in the practice of achieving sexual arousal related to restriction of breathing.’” (citing to the 5th edition of the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders).  
Continue Reading Seventh Circuit Holds that Death by Autoerotic Asphyxiation Is Excluded under AD&D Policy