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 […]
The 1st U.S. Circuit Court of Appeals has issued a major ruling on how courts are to assess employee benefit claim decisions made within the context of ERISA. In Denmark v. Liberty Life Assur.Co. of Boston, 2009 U.S.App.LEXIS 9825 (May 6), the court revisited an earlier ruling in a disability benefits claim involving fibromyalgia (Denmark […]
The impact of a recent Supreme Court ruling involving disability benefits was at issue in Chronister v. Unum Life Ins.Co. of America, 2009 U.S.App.LEXIS 9033 (8th Cir. April 30). This ruling marked the second time the 8th U.S. Circuit Court of Appeals had occasion to consider Sandra Chronister’s application for disability benefits. In the first […]
The deferential standard of review given to insurance companies in ERISA cases was subject to a rigorous examination in Kramer v. Paul Revere Life Ins. Co., 2009 U.S.App.LEXIS 7387 (6th Cir. April 8, 2009)(unpublished). There, an obstetrician and gynecologist, Dr. Lois Kramer, had two disability insurance policies underwritten by the same insurer.