Two significant rulings issued days apart upheld the authority of state departments of insurance to prohibit life and disability insurers from including discretionary clauses in their policies that would have the effect of triggering an arbitrary and capricious standard of review under the ERISA law. At issue was the adoption by several states of a […]
After a district court awarded benefits to the plaintiff, the insurer successfully appealed to the 10th U.S. Circuit Court of Appeals, which issued a ruling narrowly constraining the scope of consideration of ERISA claims under the de novo standard of adjudication. Jewell v. Life Ins.Co. of North America, 2007 U.S.App.LEXIS 27832 (Nov. 30, 2007). The […]
In Shane v. Albertson’s Inc., 2007 U.S.App.LEXIS 24092 (9th Cir. Oct. 15), Stacey Shane originally qualified for disability benefits under Albertson’s ERISA-governed disability income plan in 2000 on account of a knee injury; and benefits were paid continuously for two years. However, benefits were terminated in 2003 when the Albertson’s Medical Review Committee determined Shane […]
A recent case from the Seventh Circuit Court of Appeals indicates that insurance companies cannot expect the courts to rubber-stamp their denials of benefits.
Although unpublished, a recent case from the 6th U.S. Circuit Court of Appeals presents a number of significant issues and should be reissued as a published decision. Houston v. Unum Life Ins.Co. of America, 2007 U.S.App.LEXIS 18553 (July 27). Houston involved a claimant who worked as a housekeeping supervisor for Ritz-Carlton Hotels for more than […]
Alison Weidner, who worked for FedEx for more than 15 years, experienced a flare-up in her multiple sclerosis and applied for long-term disability payments when she became unable to work. The plaintiff’s treating neurologist certified her disability; and Broadspire, the claim administrator for the FedEx disability benefit plan, acknowledged that Weidner could not perform her […]