Since the recent decisions on the DOL’s fiduciary rule are now old news, I want to take this Monday to highlight two district court decisions on the issue of exhausting administrative remedies. The first is from a district court in the Second Circuit, Tuttle v. The Prudential Insurance Company of America, No. 3:17-CV-00100-VAB, 2018 WL 1245731 (D. Conn. Mar. 9, 2018). In Tuttle, the court determined that Plaintiff exhausted his administrative remedies where he appealed Prudential’s initial determination denying his long-term disability benefits but did not appeal Prudential’s subsequent decision to partially overturn its initial determination. The second determination upheld a substantial part of Prudential’s previous decision to deny benefits. The court agreed with Plaintiff that requiring him to appeal a second time would create “a continuous cycle of appeals from appeals.”
Continue Reading Courts Define the Meaning of “Exhausting Administrative Remedies” In Long-Term Disability Disputes
Play or Pay – Claimants and Administrators Must See the Administrative Process Through
Follow me to Tennessee! This week’s notable decisions are far apart on the spectrum, yet more similar than you might think, and not just because they’re both out of Tennessee and involve Reliance Standard Life Insurance Company. Let’s start with the bad/bizarre (for Claimants): Jordan v. Reliance Standard Life Insurance Company, No. 1:16-CV-23, 2018 WL 543041 (E.D. Tenn. Jan. 24, 2018). Jordan filed a lawsuit seeking long-term disability benefits after Reliance Standard failed to make a timely decision on her appeal. Reliance Standard’s decision was due on December 18, 2015 (45 days following the appeal submission) but Jordan did not file suit until February 5, 2016 (more than 90 days following the appeal submission). In litigation, Reliance Standard argued that Jordan failed to exhaust her administrative remedies.
Continue Reading Play or Pay – Claimants and Administrators Must See the Administrative Process Through