A recent ruling from the 1st Circuit illustrates a marked disparity between how different federal circuits adjudicate ERISA claims. In Richards v. Hewlett-Packard Corp., 2010 U.S.App.LEXIS 1010 (1st Cir., Jan. 19), the plaintiff, Edward Richards, who worked for Digital Equipment Corporation from 1984 to 1991 as a software engineer, became disabled at age 39 due […]
In McGahey v. Harvard University Flexible Benefits Plan, 2009 U.S.Dist. LEXIS 115364 (D.Mass. Dec. 11, 2009), the court wrestled with how to apply a deferential standard of review in evaluating a claim for disability benefits. The plaintiff, Rosemary McGahey, who had worked as the director of residential dining at Harvard University, injured her right knee when she slipped on ice while at work in February 2004.
Earlier this year, I wrote about a significant ruling issued by the 6th U.S. Circuit Court of Appeals, American Council of Life Insurers v. Ross, 558 F.3d 600 (March 18) (“Discretionary clauses under heavy fire, Chicago Daily Law Bulletin April 6). Ross upheld the authority of states to ban clauses in insurance policies that give insurers discretion to decide health and disability claims and thus trigger a deferential standard of court review over such claims.
The arbitrary and capricious standard of review gives employers such broad discretion to interpret benefit plan provisions that a literal reading of the plan can be overridden according to Wallace v. Johnson & Johnson, 2009 U.S.App.LEXIS 22529 (1st U.S. Circuit Court of Appeals, Oct. 14). Wallace, who spent 14 years as a manager with Johnson […]
In Montour v. Hartford Life & Accid.Ins.Co., 2009 U.S.App.LEXIS 20378 (Sep. 14), the 9th U.S. Circuit Court of Appeals has taken an approach to Glenn v. Metro.Life Ins.Co., 128 S.Ct. 2343 (2008), that requires a court reviewing a benefit decision governed by the Employee Retirement Income Security Act, 29 U.S.C. §1001 et seq., to apply […]
The 7th U.S. Circuit Court of Appeals recent ruling in Krolnik v. Prudential Ins.Co., 2009 U.S.App.LEXIS 13916 (June 29), constitutes the definitive statement as to the scope of ERISA claims adjudication under the de novo standard. Krolnik involved a relatively typical disability insurance benefit claim under a group policy issued by Prudential Insurance Company. The […]