Hello, ERISA Watchers! There have been quite a few good fee decisions as of late. This week’s notable decision is a fee decision and firm victory in Benjamin v. Oxford Health Ins., Inc., __F.Supp.3d__, 2019 WL 126190 (D. Conn. Jan. 8, 2019), a matter involving denial of residential treatment for a mental and/or behavioral health disorder. In the court’s earlier decision, Benjamin v. Oxford Health Ins., Inc., 2018 WL 3489588 (D. Conn. July 19, 2018), the court found that Plaintiff Benjamin was eligible for attorneys’ fees because the court remanded the claim to Oxford for a full and fair review. Oxford failed to consider Plaintiff’s medical records and apply its own standards of review, including failing to conduct a Medical Necessity review.
Continue Reading Claimant Entitled to Attorney’s Fees for Court-ordered Remand Despite Insurer’s Offer of Voluntary Remand
Court Awards Six Figures in Attorneys’ Fees to Claimant Who Achieved a Remand of Long-Term Disability Claim that was Ultimately Denied
Happy Memorial Day! Hope you all are reading today’s newsletter from the comfort of your lawn chair sipping mimosas. No matter what you have on the agenda, please take a moment to honor and remember everyone who has died serving in the American armed forces.
Today’s notable decision is Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., No. 5:14-CV-02524-EJD, 2018 WL 2387852 (N.D. Cal. May 25, 2018), where the court grants in part Plaintiff’s motion for attorneys’ fees and denies Defendants’ request for attorneys’ fees, even though Defendants were ultimately successful on the merits of the underlying long-term disability dispute.
Continue Reading Court Awards Six Figures in Attorneys’ Fees to Claimant Who Achieved a Remand of Long-Term Disability Claim that was Ultimately Denied
Court Orders Unsuccessful Claimant to Pay Third-Party Administrator’s Attorneys’ Fees in Lawsuit Preempted by ERISA
In ERISAland, attorneys’ fees are infrequently awarded to defendants for having to defend themselves in a matter involving a denial of disability benefits. This week’s notable decision, Hackney v. Allmed Healthcare Management, Inc., No. 3:15-CV-00075-GFVT, 2018 WL 1981902 (E.D. Ky. Apr. 27, 2018), is one of those infrequent and disappointing cases where the court orders an unsuccessful plaintiff to pay the defendant five figures in attorneys’ fees and costs. And all because the plaintiff pushed the envelope in pursuing a cause of action not generally recognized as available under ERISA.
Continue Reading Court Orders Unsuccessful Claimant to Pay Third-Party Administrator’s Attorneys’ Fees in Lawsuit Preempted by ERISA