The outcome of Employee Retirement Income Security Act cases often turns on how courts interpret the meaning of specific benefit plan terms. The recently decided case of Stein v. Paul Revere Life Insurance Company, issued by the U.S. District Court for the Eastern District of Pennsylvania on March 16, illustrates what happens when plan terms are unclear and can have different meanings. […]
DeBofsky Law is proud to announce that its founder, Mark D. DeBofsky, has been appointed as a member of the 2023 Advisory Council on Employee Welfare and Pension Benefit Plans, also known as the ERISA Advisory Council.
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. […]
You worked hard on your long term disability appeal. Hopefully, you followed our LTD claim appeal best practices when preparing your appeal. Maybe you followed our advice and hired an attorney to prepare the appeal for you. Now, the appeal is in the insurer’s hands. Despite your preparation, it is still possible for the appeal to go awry after it is submitted to the disability insurer. […]