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January 2016 Archives

What is "appropriate equitable relief"?

The ERISA statute contains a provision that permits a large universe of potential claimants to seek "appropriate equitable relief."  29 U.S.C. Sec. 1132(a)(3).  Over a series of rulings the Supreme Court has wrestled with the meaning of that term. Historically, courts of equity were limited in the remedies they could provide litigants who came before such courts.  But with a growing recognition that monetary damages were sometimes necessary to allow recovery when a wrong had been committed, the courts in England and then in America permitted courts of equity to award money damages.  Finally, in 1938, the distinction between courts of equity and courts of law was blurred as the divided bench was joined together.

Aetna and the Courts

Aetna Life Insurance Company has attracted significant judicial scorn of late in the manner in which it adjudicates disability benefits.  Two recent decisions are illustrative - Jalowiec v. Aetna Life Ins. Co., 2015 WL 9294269 (D. Minn. December 21, 2015) and Granville v. Aetna Life Ins. Co., 2015 WL 9026025 (M.D. Pa. December 15, 2015).  In Jalowiec, which involved a disability insurance claimant who suffered from daily debilitating headaches, a benefit claimant was denied long-term disability insurance benefits despite certification of his disability by several treating doctors.  The court criticized Aetna for its reliance on reviewing doctors who engaged in a selective consideration of the evidence and who never consulted with the treating doctors to seek clarification of their opinions. 

DeBofsky, Sherman & Casciari, PC