The threshold issue in every Employee Retirement Income Security Act (ERISA)-governed benefit dispute is the standard of review utilized by the court in adjudicating the claim. Following the Supreme Court’s ruling in Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989), a veritable land rush ensued as insurers and plan administrators sought to […]
A recent ruling from the 9th U.S. Circuit Court of Appeals illustrates just how critical the Employee Retirement Income Security Act (ERISA) standard of review is to the outcome of a case. In Day v. AT&T Disability Income Plan, 2012 U.S.App.LEXIS 13558 (9th Cir. July 3, 2012), the court addressed whether it would be permissible […]
A recent ruling from the 9th U.S. Circuit Court of Appeals addressed the question of whether an alleged failure to meet a statutory requirement results in the federal court losing subject matter jurisdiction.
Should courts be giving deference to benefit decisions made by insurance companies? Although the U.S. Supreme Court ruled in Firestone Tire v. Bruch, 489 U.S. 101 (1989), that deference was permissible in Employee Retirement Income Security Act (ERISA) benefit claims disputes, the court pointed out that the default standard of adjudication should be de novo, which means a court weighs the evidence afresh and gives equal consideration to both plaintiff and defendant.
In many Employee Retirement Income and Security Act (ERISA) cases, the standard of review applied by a court is often the key factor in determining the outcome of a dispute over disability cases. Such cases often involve conflicting medical opinions and, where the insurer has properly reserved discretionary authority, it almost always wins the battle […]
Two recent district court rulings ,Day v. AT&T Disability Income Plan, 2010 U.S.Dist.LEXIS 61477 (N.D.Cal. June 8, 2010) and Riley v. Sun Life and Health Assur.Co., 2010 U.S.Dist.LEXIS 61881 (D.Neb. June 18, 2010), starkly illustrate how the standard of review in ERISA cases can dramatically impact the application of offsets against benefits payable. In both […]