Life Insurance and AD&D Benefit Claims

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Your ERISA Watch – Eighth Circuit Rules That Reliance Standard’s “Haphazard System of Ships Passing in the Night” Led to a Breach of Fiduciary Duty

Skelton v. Radisson Hotel Bloomington, No. 21-2641, __ F.4th __, 2022 WL 1434778 (8th Cir. May 6, 2022) (Before Circuit Judges Gruender, Benton, and Erickson).

ERISA-governed life insurance benefit plans are typically administered jointly by the employer and an insurance company. The exact duties of each party vary from plan to plan, but often the division of responsibility is confusing. It is common for one party to be uncertain as to what the other is supposed to be doing, and frequently neither party possesses full information as to which employees have signed up for what, and whether those employees have met all the requirements for eligibility or enrollment.
Continue Reading Eighth Circuit Rules That Reliance Standard’s “Haphazard System of Ships Passing in the Night” Led to a Breach of Fiduciary Duty

Delker v. MasterCard Int’l, Inc., No. 20-3600, __ F.4th __, 2022 WL 38468 (8th Cir. Jan. 5, 2022) (Before Circuit Judges Smith, Gruender, and Stras).

Of all the benefit plans employers offer their employees, life insurance plans are usually the simplest. However, even these plans can cause headaches if they are not properly designed…

The New Year is off to an exciting start with two noteworthy appellate decisions, one favorable to a plan participant and one favorable to a plan sponsor. First up is a case in which the Eighth Circuit reversed a denial of disability benefits to a long-term recipient of such benefits: Roehr v. Sun Life Assurance Co. of Canada, No. 21-1559, __ F.4th __, 2021 WL 6109959 (8th Cir. Dec. 27, 2021) (Before Circuit Judges Kelly, Erickson, and Grasz). 

Insurers who are stuck with long-term expensive disability claims are often looking for ways to get rid of them. However, in this new decision from the Eighth Circuit, the court has warned insurers that they must be careful in how they deny those claims. While an insurer is not obligated to keep paying benefits just because it has done so in the past, it needs to have a good explanation for reversing itself, especially if it has been paying for almost a decade and the medical evidence has remained largely unchanged.
Continue Reading Eighth Circuit Warns Disability Administrators to Think Twice Before Terminating Disability Benefits, While Eleventh Circuit Allows Employer to Terminate Life Insurance Benefits Despite Written and Oral Promises That Such Benefits Would be Maintained