Hello, ERISA Watchers! I’m bringing you this mid-week report to share yesterday’s stunning decision from the Seventh Circuit Court of Appeals in Fessenden v. Reliance Standard Life Ins. Co., No. 18-1346, __F.3d__, 2019 WL 2589122 (7th Cir. June 25, 2019). Circuit Judge Barrett, authoring the panel opinion, explained that Reliance Standard could not enjoy deferential review because it blew its deadline to decide Fessenden’s appeal for long-term disability benefits. This is significant because some circuits allow plan administrators to claim “substantial compliance” when not meeting their deadlines to decide claims or appeals and invoke little or no penalty for these transgressions. The Seventh Circuit has made it clear to plan administrators: substantial compliance does not apply to ERISA’s regulatory deadlines. Make a decision on time or be subject to de novo review.
Continue Reading Seventh Circuit Holds that “Substantial Compliance” Does Not Apply to Blown Deadlines
Court Finds Administrator’s Conflict of Interest and Procedural Irregularities Warrant De Novo Review
Good morning, ERISA Watchers! Piggybacking on last week’s notable decision discussion, this week’s notable decision is McIntyre v. Reliance Standard Life Insurance Company, No. CV 17-5134 (JRT/DTS), 2019 WL 2267054 (D. Minn. May 28, 2019), a case analyzing an insurer’s history of biased claims administration when it comes to determining the conflict of interest and standard of review.
At issue in McIntyre is whether the plaintiff, a nurse disabled by Charcot Marie Tooth Syndrome (“CMT”), is entitled to long-term disability benefits under the “Any Occupation” standard in the Reliance Standard disability policy. (CMT is a neurological disorder that affects peripheral nerves.) If you’re in a hurry for the happy ending, the court’s answer is YES. Let’s examine how the court got there.
Continue Reading Court Finds Administrator’s Conflict of Interest and Procedural Irregularities Warrant De Novo Review
Court Reconsiders Application of Colorado State Ban on Discretionary Clauses Based on Disability Policy Amendments and SPD
Good morning and Happy Martin Luther King, Jr. Day! There were so many notable and circuit court decisions from this past week it was hard to choose just one noteworthy decision. I decided to go with one awesome decision that may not have gotten as much press coverage as the others – Ellis v. Liberty Life Assurance Company of Boston, No. 15-CV-00090-LTB, 2019 WL 200394 (D. Colo. Jan. 15, 2019). What I love about this decision is that it snatches victory from the jaws of defeat, but it also highlights the real difference the standard of review makes. On a motion for reconsideration, Plaintiff Ellis’s new attorneys, McDermott Law, were able to get the Court to reconsider its previous decision finding that C.R.S. § 10-3-1116(2) does not apply to the discretionary language in the relevant disability policy and entering judgment in favor of Liberty Life under an arbitrary and capricious standard of review. See Ellis v. Liberty Life Assurance Co. of Bos., 333 F. Supp. 3d 1083 (D. Colo. 2018).
Continue Reading Court Reconsiders Application of Colorado State Ban on Discretionary Clauses Based on Disability Policy Amendments and SPD