There is no provision in the Employee Retirement Income Security Act of 1974 mandating that claimants must exhaust internal appeals as a precondition to filing a lawsuit to challenge a claim denial. Nonetheless, most courts have required claimants to exhaust prelitigation appeals before their cases may be heard in court. […]
On Jan. 26, the U.S. Court of Appeals for the Ninth Circuit withdrew its prior memorandum disposition in Wit v. United Behavioral Health and replaced it with an entirely new opinion. […]
The ERISA statute, at 29 U.S.C. Sec. 1133, guarantees benefit claimants the right to a “full and fair review” of denied claims. To flesh out the meaning of what constitutes a full and fair review, the U.S. Department of Labor has issued a detailed set of regulations in 29 C.F.R. Sec. 2560.503-1 setting forth minimum standards plan administrators must meet. […]
When is a life insurance forfeiture ineffective despite the insured’s failure to make a timely premium payment? The answer was provided in Harwick v. AXA Equitable Life Ins. Co., 2020 WL 7698367 (N.D. Ill. December 27, 2020), where the court cited an Illinois statute that embodies a public policy against undue forfeiture of life insurance coverage. […]
Fraud and forgery have always been of concern in commercial transactions. And the internet age has ushed in a whole new level of criminality. […]