This week’s notable decision is from the putative class action case, Moura v. Kaiser Foundation Health Plan, Inc., No. C 17-02475 JSW, 2018 WL 1569812 (N.D. Cal. Mar. 30, 2018), which challenges Kaiser’s alleged pattern and practice of denying treatment for eating disorders in violation of ERISA and the California and Federal Health Parity Acts. The court previously granted Kaiser’s motion to dismiss the original complaint on the basis that Moura failed to allege that he exhausted his administrative remedies for the denial of his claim for treatment of anorexia nervosa. Moura then filed a first amended complaint alleging only a claim pursuant to 29 U.S.C. Section 1132(a)(3) for breach of fiduciary duty against the plan administrators.
Continue Reading Kaiser Must Defend ERISA Breach of Fiduciary Duty Claim Challenging Its Treatment of Eating Disorders
In Life Insurance Dispute, the Eleventh Circuit Holds that a Party Who Is Not a Named Beneficiary May Not Sue the Plan for Any Benefits
This week’s notable decision is Metlife Life & Annuity Co. of Connecticut v. Akpele, No. 16-15677, __F.3d__, 2018 WL 1527147 (11th Cir. Mar. 29, 2018), an interpleader action brought by MetLife to determine the proper beneficiary to the proceeds of a life insurance policy purchased by Dr. Akpele to fund the AIE Surgical Practice Defined Benefit Plan that he had established as its sole member and trustee pursuant to ERISA. The case involves a complicated procedural history, so I’ll just summarize the major issues the Eleventh Circuit decided as to the proper amount and beneficiary of the disputed proceeds.
Continue Reading In Life Insurance Dispute, the Eleventh Circuit Holds that a Party Who Is Not a Named Beneficiary May Not Sue the Plan for Any Benefits
No Remedy for Breach of Fiduciary Duty Related to Group Life Insurance Enrollment
This week’s notable decision, Schwartz v. Keolis Commuter Servs., No. 16-CV-11506-LTS, 2018 WL 1411202 (D. Mass. Mar. 20, 2018), involves the mishandling of an employee’s group life insurance enrollment and evidence of insurability. Though post-Cigna Corp. v. Amara we have seen courts find cognizable claims for breaches of fiduciary duty that used to have no remedy, this unfortunate case is an example of when a breach of fiduciary duty lacks a remedy because there is no recognizable harm.
In this case, the employee, Sofiya Schwartz, started working for Massachusetts Bay Commuter Railroad Company (“MBCR”) in February 2005. A few years later, she attempted to enroll for Supplemental Life Benefits in the amount of two times her salary. Because she was a late entrant, she also submitted to MBCR evidence of insurability, which MBCR forwarded to Unum. Unum denied her request due to her history of myelopathy.
Continue Reading No Remedy for Breach of Fiduciary Duty Related to Group Life Insurance Enrollment