The disability insurance policy at issue in a federal court decision acknowledged that the insurer was a fiduciary and had discretion to determine eligibility for benefits and construe the policy terms. The policy further stated that ERISA fiduciaries ”have an obligation to administer the plan prudently and to act in the interest of you and […]
The current regime of treating claims administered by health and disability insurers in the same manner as pension benefit claims has proven to be a recipe for disaster. First and foremost on the agenda for fixing the current system is the need to improve the communications provided to plan participants and their beneficiaries. Judge Richard […]
Deadlines carry little weight if there are no repercussion for missing them. Take the case of Gatti v. Reliance Standard Life Insurance Co., 2005 U.S.App.LEXIS 9895 (9th Cir., May 31), which involved a claimant who received disability benefits for nearly seven years due to complications of Hepatitis B. The insurer cut off benefits in 2000, […]
After winning summary judgment in the trial court, plaintiff Linda Ellis suffered a crushing defeat in the 5th U.S. Circuit Court of Appeals, which rejected her claim for disability coverage.Ellis v. Liberty Life Assurance Company of Boston, 2004 U.S.App.LEXIS 24199 (5th Cir., Nov. 19). Ellis was a loan officer for Chase Manhattan Bank until 1999, […]
For the last year, there has been an ongoing debate in the federal court in Philadelphia as to whether the Employee Retirement Income Security Act, 29 U.S.C. sec1001, et seq., preempts claims involving insured benefits such as disability or health insurance disputes brought under Pennsylvania’s bad-faith statute, 42 Pa.C.S. sec8371. On the one side are […]