Good morning, ERISA Watchers! There was an unprecedented number of ERISA decisions decided this past week. Curious, I did some research and realized that March 31st is a semiannual deadline under The Civil Justice Reform Act of 1990, which requires the Director of the Administrative Office of the United States Courts, under 28 U.S.C. § 476, to prepare a semiannual report showing all motions pending more than six months and all civil cases pending more than three years. Coincidence? I think not. The next reporting deadline is September 30th. That seems like a good week for me to be on vacation!
Continue Reading First Post-Ariana M. de novo Trial of Disability Claim Denial Results In Win for Claimant Against The Hartford
No Preemption! 9th Circuit Revives Employers’ State-Law Claims Against Health Insurance Companies for Hidden Surcharges and Kickbacks
Good morning, ERISA Watchers! I just returned from the ABA Employee Benefits Committee Mid-Winter Meeting in Nashville, where I got to see many of you and add several new subscribers! As a reminder, and for the new folks, all the cases discussed in this newsletter are hyperlinked to the full text of the decision if you want to read more.
The first of this week’s notable decisions is The Depot, Inc. v. Caring for Montanans, Inc., No. 17-35597, __F.3d__, 2019 WL 453485 (9th Cir. Feb. 6, 2019), a published decision from the Ninth Circuit addressing fiduciary actions, plan assets, remedies and preemption.
Continue Reading No Preemption! 9th Circuit Revives Employers’ State-Law Claims Against Health Insurance Companies for Hidden Surcharges and Kickbacks
Seventh Circuit Questions MetLife’s Interpretation of Neuromusculoskeletal Limitation in Long Term Disability Plan
This week’s notable decision involves the denied long-term disability dispute in Hennen v. Metropolitan Life Insurance Company, No. 17-3080, __F.3d__, 2018 WL 4376994 (7th Cir. Sept. 14, 2018). The Seventh Circuit overturned the grant of summary judgment to MetLife and remanded the case to MetLife for further proceedings. The dispute centers on MetLife’s application of its “neuromusculoskeletal and soft tissue disorders” provision, which limits payment for disabilities caused by these conditions to just twenty-four months. Exceptions to this limitation are disabilities caused by radiculopathy. MetLife defined radiculopathy as “Disease of the peripheral nerve roots supported by objective clinical findings of nerve pathology.”
Continue Reading Seventh Circuit Questions MetLife’s Interpretation of Neuromusculoskeletal Limitation in Long Term Disability Plan