Retirement plan participants received a partial victory from the Eighth Circuit Court of Appeals in one of several actions brought against large universities for the alleged mismanagement of their section 403(b) retirement-savings plans. In Davis v. Washington Univ. in St. Louis, No. 18-3345, __F.3d__, 2020 WL 2609865 (8th Cir. May 22, 2020), the plan participants alleged two separate breach of fiduciary duty claims. The first claim alleges that Washington University allowed the investment-management fees and record-keeping expenses “to get out of control.” The second claim alleges that Washington University allowed several underperforming investments to stay in the plan for too long. The district court (E.D. Mo. – St. Louis) granted the University’s motion to dismiss both claims. The plan participants appealed. The Eighth Circuit affirmed in part, reversed in part, and remanded for further proceedings. Continue Reading Eighth Circuit Revives Excessive Fee Litigation against Washington University

Good morning, ERISA Watchers! We have two notable decisions to report again this week, including one that is a firm victory. 

Let us start with the good news. The first notable decision, Katherine P. v. Humana Health Plan, Inc., No. 19-50276, __F.3d__, 2020 WL 2479687 (5th Cir. May 14, 2020), revives life into a claim by a young woman seeking mental health benefits for partial hospitalization treatment. Katherine received partial hospitalization treatment in 2012 for multiple mental health disorders including an eating disorder. Humana paid for the first 12 days of partial hospitalization treatment and then denied benefits, claiming such treatment was no longer medically necessary based on two Mihalik Criteria. The parties filed cross-motions for summary judgment and the magistrate judge recommended judgment for Humana. The district court accepted the recommendation. Katherine P. appealed.  Continue Reading Fifth Circuit Revives Claim Against Humana for Denying Eating Disorder Treatment

Good morning, ERISA Watchers! There were no notable circuit court decisions this past week, so we have chosen to highlight two published district court decisions from matters involving disability claims. The first is favorable to plan participants and the second is not. Is it any surprise that the former is from within the Ninth Circuit? 

Enjoy the long read of the summaries below. Until next week. Stay safe and be well.

The first case:  Jones v. Life Ins. Co. of N. Am., No. CV-19-04669-PHX-DLR, __ F. Supp. 3d __, 2020 WL 2126498 (D. Ariz. May 5, 2020). The almost Sisyphean topic of discovery in ERISA benefits cases added a new page when, on de novo review, the court required LINA “to respond to discovery that delves into the number of times it retained and the amount of money it paid to third-party vendors in disability and LWOP claims and medical reviewers utilized here, LINA-generated performance evaluations of the vendors and medical reviewers, the number of times they concluded that a claimant could perform work, LINA-generated performance evaluations for LINA employee Mary Faltaous, and any guidelines and manuals used by LINA in evaluating this claim, including the ‘DMS Expert Resource Professional conduct Statement’ and any guidelines and manuals.”  Continue Reading District Court Permits Vast Conflict Discovery in Life Waiver of Premium Dispute Subject to De Novo Review