This week we just couldn’t choose between two cases in which ERISA plan participants were told that they could not qualify for benefits, despite serious medical conditions documented by their doctors.

The first case, Ovist v. Unum Life Ins. Co. of Am., No. 20-1464, __ F.4th __, 2021 WL 4304547 (1st Cir. Sept. 22, 2021) (Before Circuit Judges Lynch and Selya, and District Judge Joseph N. Laplante), involved the denial of a claim for disability benefits.

Some disabilities are easier to identify and measure than others. In cases where the primary disabling symptoms include pain, weakness, or fatigue, insurers often battle with their insureds over whether those symptoms exist, and if so, how debilitating they are. Continue Reading Downright Unreasonable: Two Circuits Uphold Benefit Denials

Warmenhoven v. NetApp, Inc., No. 19-16960, __ F.4th __, 2021 WL 4143107 (9th Cir. Sept. 13, 2021) (Before Circuit Judges Christen and Bade, and District Judge Gary Feinerman).

Although ERISA does not require that welfare benefits vest, courts recognize that they can vest when an employer promises to provide such benefits for life. This case explores the thorny issue of when such a promise of lifetime healthcare benefits is irrevocable and, if not irrevocable, when such a promise constitutes a fiduciary breach and therefore lay the foundation for an equitable relief claim.  Continue Reading Promises, Promises: Statements in a PowerPoint About Lifetime Health Benefits May Bind Employer

Smith v. Board of Directors of Triad Mfg., Inc., No. 20-2708, __ F.4th __, 2021 WL 4129456 (7th Cir. Sept. 10, 2021) (Before Circuit Judges Kanne, Brennan, and Scudder).

Arbitration is a hot issue in ERISA. Can claims for relief under ERISA be forced into arbitration, and if so, when? In this case the Seventh Circuit has good news and bad news for litigants on both sides.

The case is a putative class action brought by James Smith, an employee of Triad Manufacturing, Inc., alleging that in 2015 Triad and related defendants mismanaged Triad’s ERISA-governed employee stock ownership plan. Specifically, Smith alleged that three members of the board of directors created the plan and sold all of Triad’s stock to the plan, which then plummeted in value. The directors, however, profited from the transaction by providing loans to the plan that required repayment, regardless of Triad’s financial situation. In 2018, defendants amended the plan to include an arbitration provision with a class action waiver that prohibited claimants from seeking a remedy “which has the purpose or effect of providing additional benefits or monetary or other relief to any Eligible Employee, Participant or Beneficiary other than the Claimant.” Continue Reading Arbitration Provision That Prevents Plan-Wide Relief Unenforceable