Author: Mark Debofsky

Rulings uphold state power over review clauses

Two significant rulings issued days apart upheld the authority of state departments of insurance to prohibit life and disability insurers from including discretionary clauses in their policies that would have the effect of triggering an arbitrary and capricious standard of review under the ERISA law. At issue was the adoption by several states of a […]

A painful burden for disability claimants

Welch v. Unum Life Ins. Co. of America, 2007 U.S.Dist.LEXIS 91796 (D.Kansas Dec. 13, 2007), was before the court on remand from the 10th U.S. Circuit Court of Appeals (Welch v. Unum Life Insur. Co. of America , 382 F.3d 1078 (10th Cir. 2004), where the appellate court ruled that consideration had to be given […]

10th Circuit sticks to ‘review proceeding’

After a district court awarded benefits to the plaintiff, the insurer successfully appealed to the 10th U.S. Circuit Court of Appeals, which issued a ruling narrowly constraining the scope of consideration of ERISA claims under the de novo standard of adjudication. Jewell v. Life Ins.Co. of North America, 2007 U.S.App.LEXIS 27832 (Nov. 30, 2007). The […]