WASHINGTON, D.C. — The U.S. Supreme Court on May 28 denied a disability claimant’s petition for writ of certiorari, refusing to review the Sixth Circuit U.S. Court of Appeals’ decision that the disability claimant was not disabled from his own occupation as an anesthesiologist because the medical evidence supported the insurer’s finding that the claimant could perform the duties of his own occupation with appropriate accommodations (Timothy O’Neill D.O. v. Unum Life Insurance Company of America, No. 18-1305, U.S. Sup.).
CINCINNATI — A Michigan federal judge did not err in denying a mother equitable relief under the Employee Retirement Income Security Act in her efforts to recover benefits under her son’s accidental death and dismemberment policy (AD&D policy), the Sixth Circuit U.S. Court of Appeals ruled May 23 (Karen Briggs v. National Union Fire Insurance Company, et al., No. 18-1828, 6th Cir., 2019 U.S. App. LEXIS 15302).
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on May 23 reversed and remanded a district court’s ruling in favor of a disability claimant after determining that the insurer’s denial of benefits was not an abuse of discretion because, according to Fifth Circuit precedent, the insurer properly considered the general duties of the claimant’s regular occupation and did not have to account for each of the claimant’s unique job duties (Juanita Nichols v. Reliance Standard Life Insurance Co., No. 18-60499, 5th Cir., 2019 U.S. App. LEXIS 15396).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on May 22 granted a petition for en banc rehearing filed by a number of trusts that administer multiemployer plans, agreeing to reconsider its decision that a repealed Nevada law that limits the damages that may be collected from general contractors who are vicariously liable for the debts of Employee Retirement Income Security Act plan members is not preempted by ERISA and does not conflict with ERISA’s objectives or impermissibly “relate” to ERISA plans (The Board of Trustees of the Glazing Health and Welfare Trust, et al. v. Shannon Chambers, No. 16-15588, 9th Cir.).
SEATTLE — The Ninth Circuit U.S. Court of Appeals on May 21 determined that a district court did not err in finding that a disability insurer properly calculated a claimant’s long-term disability (LTD) benefits because the claimant’s benefits were calculated in accordance with the plan’s terms (Deborah A. Johnson v. General Electric Co. et al., No. 18-35581, 9th Cir., 2019 U.S. App. LEXIS 15019).
ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on May 16 denied a petition for rehearing en banc, refusing to reconsider its decision that a class of retirees’ health benefits were not vested as a matter of law (Augustine Pacheco, et al. v. Honeywell International Inc., Nos. 18-1006 and 18-1294, 8th Cir.).
WASHINGTON, D.C. — In a May 21 brief filed with the U.S. Supreme Court, the U.S. solicitor general argues that the Eighth Circuit U.S. Court of Appeals erroneously found that a putative plaintiff class lacks statutory standing under the Employee Retirement Income Security Act to maintain an action against their pension plan because the plan was subsequently overfunded (James J. Thole, et al. v. U.S. Bank, N.A., et al., No. 17-1712, U.S. Sup.).
PHILADELPHIA — An anti-assignment provision in an insured’s medical benefits plan clearly bars an insured from assigning his rights under the plan to a medical provider, the Third Circuit U.S. Court of Appeals said May 16 in affirming a district court’s dismissal of the medical provider’s complaint against the medical insurer (University Spine Center, on assignment of John W. v. Aetna Inc., et al., No. 18-2842, 3rd Cir., 2019 U.S. App. LEXIS 14588).
SAN FRANCISCO — A California federal judge erred in denying the surviving domestic partner of a benefit plan participant spousal benefits after the plan participant died, a Ninth Circuit U.S. Court of Appeals panel ruled May 14 (David R. Reed v. KRON/IBEW Local 45 Pension Plan, et al., No. 17-17176, 9th Cir., 2019 U.S. App. LEXIS 14581).
ATLANTA — Insubstantial procedural errors do not require anything other than the capricious and arbitrary standard in an Employee Retirement Income Security Act case challenging an insurer’s denial of coverage for eating disorder treatments, an 11th Circuit U.S. Court of Appeals panel held May 15 (O.D. v. Jones Lang LaSalle Medical PPO Plus Plan, No. 17-13060, 11th Cir., 2019 U.S. App. LEXIS 14385).
CHICAGO — In a May 13 notice of supplemental authority, appellees told the Seventh Circuit U.S. Court of Appeals that contrary to the position taken by a group of retirement plan participant appellants, a recent decision by the Third Circuit does not support reversal of an Illinois federal judge’s dismissal of allegations that Northwestern University breached its fiduciary duties (Laura L. Divane, et al. v. Northwestern University, et al., No. 18-2569, 7th Cir.).
NEW YORK — A New York federal judge’s rejection on res judicata grounds of allegations that a plaintiff was wrongfully denied retirement benefits was affirmed May 8 by the Second Circuit U.S. Court of Appeals (Kathleen Whelehan v. Bank of America Benefit Appeals Committee, et al., No. 18-2668, 2nd Cir., 2019 U.S. App. LEXIS 14052).
NEW YORK — A New York federal judge on May 9 granted a 401(k) plan participant’s motion to amend a complaint to add a breach of fiduciary claim after determining that the participant sufficiently alleged facts in support of the allegation that the plan defendants retained a plan fund despite the fund’s higher fees and lower performance (Arthur Bekker, et al. v. Neuberger Berman Group LLC, et al., No. 16-6123, S.D. N.Y., 2019 U.S. Dist. LEXIS 79149).
WASHINGTON, D.C. — The U.S. Supreme Court should refuse to review the District of Columbia Circuit U.S. Court of Appeals’ decision on whether equitable remedies other than disgorgement are available on pension plan participants’ breach of fiduciary duty claim because there is no conflict with the decisions of other circuits and because review at this stage of the litigation would be premature, the plan trustee says in its May 8 respondent’s brief (K. Wendell Lewis, et al. v. Pension Benefit Guaranty Corp., No. 18-1279, U.S. Sup.).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on May 8 held that a lower federal court should have allowed a widow to submit evidence rebutting the denial of benefits under an accident plan, finding that the court’s failure to do so of necessity affected its finding that the life insurer had no more than a structural conflict of interest, vacating and remanding the lower court’s judgment in an Employee Retirement Income Security Act lawsuit (Marnie Masuda-Cleveland v. Life Insurance Company of North America, No. 17-17149, 9th Cir., 2019 U.S. App. LEXIS 13782).
CINCINNATI — The Sixth Circuit U.S. Court of Appeals issued a mandate on April 4 after denying Hoover Co. retirees’ petition for rehearing en banc of a divided panel ruling that the obligation to provide lifetime health care benefits promised in multiple collective bargaining agreements (CBA) ended when the last CBA ended (Joseph Zino, et al. v. Whirlpool Corp., et al., Nos. 17-3851, 17-3860, 6th Cir.).
WASHINGTON, D.C. — Chevron Corp. on May 3 waived its right to respond to a petition for a writ of certiorari filed by participants in its Employee Savings Investment Plan asking the U.S. Supreme Court to decide whether a plaintiff alleging breach of fiduciary duty under the Employee Retirement Income Security Act can make a sufficient pleading with an allegation of a deficient decision-making process through inferences from facts known to the plaintiff (Charles E. White, Jr., et al. v. Chevron Corporation, et al., No. 18-1271, U.S. Sup.).
WASHINGTON, D.C. — Pension Benefit Guaranty Corp. (PBGC) told the U.S. Supreme Court in an April 30 letter that it waives its right to respond to a petition for certiorari asking the proper standard for successor liability for unpaid Employee Retirement Income Security Act pension obligations (September Ends Co., et al. v. Pension Benefit Guaranty Corp., No. 18-1265, U.S. Sup.).
BOSTON — While the exact amount of Massachusetts’ alleged injury from rules granting expanded employers expanded exemptions to the Patient Protection and Affordable Care Act (ACT) may not be known, it stands to reason that it is not zero and provides injury and standing, a First Circuit U.S. Court of Appeal panel held May 2 (Massachusetts v. United States Department of Health and Human Services, et al., No. 18-1514, 1st Cir., 2019 U.S. App. LEXIS 13293).
SAN FRANCISCO — A judge’s conclusion that an insurer violated the standards of care in denying coverage for intensive residential health care and substance abuse treatments requires changes to its business practices and court instruction on the processing of claims, plaintiffs in two Employee Retirement Income Security Act class actions told a federal judge in California on May 3. But in a motion seeking decertification of the class filed the same day, the insurer says the plaintiffs have not shown that common issues dominate the case (David and Natasha Wit, et al. v. United Behavioral Health, No. 14-02346, Gary Alexander, et al. v. United Behavioral Health, No. 14-5337, N.D. Calif.).