Mealey's ERISA
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December 07, 2023
Disability Claimant’s Suit Administratively Closed Until Insurer Decides Appeal
DENVER — A Colorado federal judge adopted a magistrate judge’s recommendation to administratively close a disability claimant’s suit seeking a declaration that long-term disability (LTD) benefits are owed under a disability plan to allow the disability insurer to issue a decision on the claimant’s appeal.
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December 07, 2023
Judgment Entered For Disability Claimant; Own-Occupation Benefits Owed
SANTA ANA, Calif. — A California federal judge issued a judgment in favor of a disability claimant after determining that the claimant is owed long-term disability (LTD) benefits because the claimant met his burden that he remains disabled from performing the duties of his own occupation.
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December 07, 2023
Termination Of LTD Benefits Was Not Abuse Of Discretion, Magistrate Judge Says
PITTSBURGH — A disability plan’s termination of long-term disability (LTD) benefits was not an abuse of discretion because the evidence shows that the claimant was not disabled from performing the duties of any occupation as required by the plan, a Pennsylvania federal magistrate judge said in recommending that the plan’s motion for summary judgment be granted and the claimant’s motion for summary judgment be denied.
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December 07, 2023
Acting Labor Secretary, Big TPA Spar Over Retrospective Claims In ERISA Case
MADISON, Wis. — Arguing that Congress left “retrospective benefits claims only to participants and beneficiaries,” the third-party administrator (TPA) of hundreds of self-funded employee welfare benefit plans urged a Wisconsin federal court to dismiss all backward-looking claims in Acting U.S. Department of Labor Secretary Julie A. Su’s suit over hospital emergency services and urinary drug screening claims.
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December 07, 2023
Disability Claimant Files Notice Of Appeal In Dispute Over ‘Any Occupation’ Benefits
DENVER — A disability claimant filed a notice of appeal to the 10th U.S. Circuit Court of Appeal after a Colorado federal judge ruled that the disability insurer’s termination of the claimant’s disability benefits was reasonable because the insurer fully investigated the claim before concluding that the claimant was not disabled from performing the duties of any occupation.
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December 07, 2023
Disability Claimant Seeks High Court Review On Claims Procedure Regulations
WASHINGTON, D.C. — A disability claimant urges the U.S. Supreme Court to grant a petition for writ of certiorari to review whether the Sixth Circuit U.S. Court of Appeals properly determined whether violations of claims procedure regulations under the Employee Retirement Income Security Act can be excused if the disability plan claims administrator substantially complied with the regulations.
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December 07, 2023
Disability Plan Did Not Abuse Discretion In Terminating LTD Benefits, Judge Says
MINNEAPOLIS — A disability plan did not abuse its discretion in terminating a claimant’s long-term disability (LTD) benefits after four years of paying the claimant benefits because substantial evidence, including a statement from the claimant’s treating doctor that he was able to return to work, supports the plan’s decision, a federal judge in Minnesota said.
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December 06, 2023
10th Circuit Reverses, Finds ERISA Arbitrary And Capricious Standard Viable
DENVER — The arbitrary and capricious review standard still applies in Employee Retirement Income Security Act cases, but an insurer’s denial letter fails to meet the standard under recent precedent requiring that such documents provide a comprehensive and specific explanation of the reasons for denying coverage, a 10th Circuit U.S. Court of Appeals panel said Dec. 5 in reversing summary judgment in favor of the insurer.
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December 06, 2023
$1M Resolution Of COBRA Suit Gets Preliminary OK, Minus General Release Payments
TAMPA, Fla. — Ruling that $7,500 general release payments for two named plaintiffs “are disguised incentive awards,” a Florida federal judge on Dec. 5 ordered references to the payments struck but otherwise granted preliminary approval of a $1 million class settlement in a case over Consolidated Omnibus Budget Reconciliation Act (COBRA) notices.
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December 06, 2023
After Bench Trial, Judge Rules Against Class In ERISA Row Over Single-Stock Fund
ALEXANDRIA, Va. — After a bench trial, a Virginia federal judge on Dec. 5 ruled that the administrator of a 401(k) plan “acted with procedural prudence” regarding divestiture of a single-stock fund and so “did not breach its duty to diversify” under the Employee Retirement Income Security Act by not acting earlier.
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December 05, 2023
Plaintiffs: Proposed Rule Undermines DOL’s Position In ERISA Fiduciary Test Row
DALLAS — A proposed rule from the U.S. Department of Labor (DOL) “highlights the disingenuousness of the DOL’s denials” in a case concerning what had been called the DOL’s “new interpretation” of a test for whether financial professionals are acting as investment advice fiduciaries under the Employee Retirement Income Security Act, plaintiffs tell a Texas federal court in a Dec. 4 brief.
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December 04, 2023
2nd Circuit Nixes Bid For Interlocutory Appeal Of ERISA Class Certification
NEW YORK — A Second Circuit U.S. Court of Appeals panel denied a petition for interlocutory appeal in which a life insurer and related entities argued that the certified class in the case over calculation of benefits was “deliberately gerrymandered” and that “there was a complete disconnect between the expert evidence and the legal basis for Plaintiffs’ claim.”
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December 04, 2023
Petitioners Argue ‘New Burdens’ In Seeking Review Of 10th Circuit ERISA Ruling
WASHINGTON, D.C. — Challenging two aspects of a 10th Circuit U.S. Court of Appeals ruling concerning long-term residential treatment facility coverage and arguing that the opinion improperly “imposes new burdens on health benefits plans,” one such plan and the insurer that administers it have petitioned the U.S. Supreme Court for a writ of certiorari.
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December 04, 2023
Class Deal Of Nearly $4M Gets Preliminary OK In ERISA Fees, Funds Lawsuit
ATLANTA — A Georgia federal judge on Dec. 1 granted preliminary approval of a $3,925,000 class settlement in an Employee Retirement Income Security Act case where the plaintiffs allege mismanagement of a 401(k) plan.
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December 04, 2023
$250,000 ERISA Deal Would Let Plaintiff Appeal Dismissed Investment Claims
SAN FRANCISCO — Under a preliminary approval motion in California federal court, a certified class would settle the remaining record-keeping claims in an Employee Retirement Income Security Act case for $250,000 while reserving the right to appeal the June 2021 dismissal of investment claims.
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December 01, 2023
$6M Class Settlement Proposed In ERISA Case Over Former ESOP Sponsored By Bank
CHARLOTTESVILLE, Va. — Dozens of individuals would receive an estimated average net settlement amount of “a little over $30,000” under a $6 million class deal concerning the Virginia Community Bankshares Inc. Employee Stock Ownership Plan (ESOP) that a Virginia federal court has been asked to preliminarily approve.
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December 01, 2023
After Prohibited Transaction Ruling, Class Asks 2nd Circuit To Rehear ERISA Case
NEW YORK — Arguing in part that the challenged decision focusing on a prohibited transaction claim “severely weakens [the Employee Retirement Income Security Act’s] high fiduciary standard,” retirement plan participants whose unsuccessful appeal essentially sought revival of the bulk of their class action petitioned the Second Circuit U.S. Court of Appeals for panel or en banc rehearing.
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November 30, 2023
Judge: Conclusory Claims About Assignment Of Rights Can’t Save ERISA Action
TRENTON, N.J. — A chiropractic and acupuncture services provider’s conclusory statements about assignment of rights do not suffice for Employee Retirement Income Security Act claims, and any amended complaint should lay out the specific contract provisions the insurer allegedly violated, a federal judge in New Jersey said in dismissing a case on Nov. 29.
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November 28, 2023
10th Circuit Revives ERISA Claim For Violation Of Parity Act In Coverage Row
DENVER — Reversing and remanding dismissal of a Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA or Parity Act) claim in a case over residential mental health treatment, a 10th Circuit U.S. Court of Appeals panel ruled in part that the insureds “plausibly alleged a disparity between the treatment limitations applied to benefits for mental health or substance abuse care compared to those applied to benefits for medical or surgical care.”
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November 28, 2023
Settlement Of ERISA Case Over Hedge Fund Gets Final OK; $10M Goes To Attorneys
NEW YORK — A $30 million Employee Retirement Income Security Act class settlement has won final approval, with a New York federal judge also granting requests for attorney fees of $10 million and a case contribution award of $30,000 to the plaintiff who sued Verizon Communications Inc. and related entities over what she calls “a hedge fund ‘fund of funds.’”
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November 27, 2023
Judge Orders Insurer To Fully Compensate Man For Proton Beam Therapy
ALEXANDRIA, La. — An insurer found liable for proton beam therapy (PBT) treatments a man paid for out of pocket after being denied coverage may not retroactively try to compensate him at in-network rates, a federal judge in Louisiana said in granting a motion to enforce judgment and ordering the insurer to fully compensate him after the Fifth Circuit U.S. Court of Appeals affirmed the award.
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November 22, 2023
$4.5M Deal Proposed In ERISA Lawsuit Over Proprietary Index Funds
NEW YORK — A New York federal court has been asked to preliminarily approve a $4.5 million class settlement in an Employee Retirement Income Security Act case over the selection and retention of proprietary index fund products.
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November 22, 2023
Class Settlement Of Nearly $4M Proposed In ERISA Revenue-Sharing Row
ATLANTA — Plaintiffs in an Employee Retirement Income Security Act case alleging mismanagement of a 401(k) plan have asked a Georgia federal court for preliminary approval of a $3,925,000 settlement under which they say an estimated 40,000 class members would get an average of about $100 apiece before expenses and attorney fees.
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November 22, 2023
Plaintiff Loses Fiduciary Exception Dispute In ERISA Privilege Ruling
SAN DIEGO — Finding that fiduciary exception to attorney-client privilege does not apply to the communications in issue in the Employee Retirement Income Security Act case, a California federal magistrate judge ruled for the defendants in a discovery dispute involving a qualified domestic relations order (QDRO).
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November 21, 2023
DOL Files Amicus Brief In ERISA Effective Vindication Row Involving ESOP
NEW ORLEANS — Urging a ruling like those issued in three other circuits under the “effective vindication” exception, acting U.S. Department of Labor Secretary Julie Su filed an amicus curiae brief asking the Fifth Circuit U.S. Court of Appeals to uphold a decision declining to compel arbitration in a putative Employee Retirement Income Security Act class case.