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Peter Sessions

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Peter S. Sessions is a partner at Kantor & Kantor who has been with the firm since 2004. Peter represents individual clients seeking health, life, and disability benefits, typically under employee health plans.

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Smith v. Board of Directors of Triad Mfg., Inc., No. 20-2708, __ F.4th __, 2021 WL 4129456 (7th Cir. Sept. 10, 2021) (Before Circuit Judges Kanne, Brennan, and Scudder).

Arbitration is a hot issue in ERISA. Can claims for relief under ERISA be forced into arbitration, and if so, when? In this case the Seventh Circuit has good news and bad news for litigants on both sides.

The case is a putative class action brought by James Smith, an employee of Triad Manufacturing, Inc., alleging that in 2015 Triad and related defendants mismanaged Triad’s ERISA-governed employee stock ownership plan. Specifically, Smith alleged that three members of the board of directors created the plan and sold all of Triad’s stock to the plan, which then plummeted in value. The directors, however, profited from the transaction by providing loans to the plan that required repayment, regardless of Triad’s financial situation. In 2018, defendants amended the plan to include an arbitration provision with a class action waiver that prohibited claimants from seeking a remedy “which has the purpose or effect of providing additional benefits or monetary or other relief to any Eligible Employee, Participant or Beneficiary other than the Claimant.”
Continue Reading Arbitration Provision That Prevents Plan-Wide Relief Unenforceable

Williams v. Unum Life Ins. Co. of Am., No. 20-1694, __ F.4th __, 2021 WL 3729660 (8th Cir. Aug. 24, 2021) (Before Circuit Judges Smith, Arnold, and Stras).

Ever since the Supreme Court’s 1989 decision in Firestone Tire & Rubber v. Bruch, ERISA-governed benefit plans and their insurers have sought to grant themselves discretionary authority in order to ensure a favorable standard of review in court.Continue Reading Eighth Circuit Rules Maine’s Anti-Discretion Law Does Not Apply to Accident Policies

Hendricks v. Aetna Life Ins. Co., No. CV 19-06840-CJC(MRWx), 2021 WL 2497950 (C.D. Cal. June 11, 2021) (Judge Cormac J. Carney).

As modern medicine advances, so do health care costs. Health insurers have an incentive to keep those costs down, and one way to do that is to deny claims for benefits by classifying expensive new treatments as “experimental and investigational.”

This case involves plaintiffs’ benefit claims for lumbar artificial disc replacement (“ADR”), a new alternative to traditional spinal fusion. Lumbar ADR has shown promise because it has the potential to provide improved flexibility and mobility to patients with spinal problems. The FDA has approved at least two lumbar disc replacement products, in 2004 and 2006.
Continue Reading Court Certifies Class Action Challenging Aetna’s Benefit Denials for Lumbar Artificial Disc Replacement