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Wash. ERISA ruling paves way for access to health benefits

The scope and breadth of the Employee Retirement Income Security Act’s statutory preemption of state laws that relate to employee benefit plans[1] has confounded the courts since ERISA was enacted in 1974. In recent years, a battle front has emerged over the power of local governments to ensure universal health care for workers. The U.S. District […]

It’s time to end mental illness bias in disability insurance

The civil rights movement made the abolition of all forms of discrimination a matter of public policy. Notwithstanding the tremendous strides that have been made to redress discrimination of all types, one group that continues to be subjected to long-standing stigmatization and social isolation are those who suffer from mental illness. The high watermark of […]

6th Circ. ruling offers fresh look at ERISA exhaustion

Is exhaustion of administrative remedies in challenging Employee Retirement Income Security Act-governed benefit denials required as a precondition to filing a lawsuit? A concurring opinion in Wallace v. Oakwood Healthcare Inc.[1] by U.S. Circuit Judge Amul Thapar of the Sixth Circuit raises provocative questions about the administrative exhaustion doctrine in ERISA cases and suggests that other […]

Accidental death ruling highlights flaw in ERISA deference

Since the publication in 1943 of James M. Cain’s noir classic, “Double Indemnity,” there has been a public fascination with accidental death insurance. Surprisingly, even when a sudden and unexpected death occurs other than as a result of a heart attack or other clear-cut medical condition, the issue of whether the death was accidental or […]

Behavioral health ruling supports benefit claim appeals

Litigating health benefit claim denials is extremely challenging for plaintiffs. Especially under the Employee Retirement Income Security Act — where many cases are decided under the arbitrary and capricious standard of review that upholds an insurance claim denial so long as the basis for the claim decision is viewed as reasonable by a court —overturning […]

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