Author: Mark Debofsky

Turning up the power of the lens raises the heat

Today’s case demonstrates that the actions of benefits administrators are worth some thought on the part of a plaintiff lawyer looking to heighten the level of scrutiny that is applied by a reviewing court. Kosiba v. Merck & Co., 2004 U.S.App.LEXIS 19164 (3d Cir. 9/14/2004). Anyone who litigates cases brought under the ERISA statute (Employee […]

Ruling undercuts ERISA promise of protection

For the last year, there has been an ongoing debate in the federal court in Philadelphia as to whether the Employee Retirement Income Security Act, 29 U.S.C. sec1001, et seq., preempts claims involving insured benefits such as disability or health insurance disputes brought under Pennsylvania’s bad-faith statute, 42 Pa.C.S. sec8371. On the one side are […]

Preexisting conditions: symptoms vs. diagnosis

The 3d U.S. Circuit Court of Appeals recently confronted the question of whether a “preexisting” condition really was preexisting and thus precluded insurance coverage. McLeod v. Hartford Life and Accident Insurance Co., 2004 U.S.App.LEXIS 12253 (3d Cir., June 22). Plaintiff Shirley McLeod, who had been receiving treatment for a variety of illnesses beginning in 1997, […]