The Employee Retirement Income Security Act law creates a number of perverse incentives for insurers that administer benefit claims. Without the availability of remedies beyond the restoration of benefits due, insurers can earn significant profits on delayed payments. A recent 6th U.S. Circuit Court of Appeals ruling, Rochow v. Life Ins. Co. of North America, […]
The Federal Rules of Civil Procedure are intended to apply to all civil actions adjudicated in federal court. However, without explanation, Employee Retirement Income Security Act(ERISA) cases receive different treatment, especially cases that involve disability insurance benefits. Although depositions of claim adjusters are routine in other insurance disputes, they are almost unheard of in ERISA […]
Despite the fact that the Federal Rules of Civil Procedure are intended to apply to all civil actions adjudicated in federal court, ERISA cases receive different treatment, especially cases that involve disability insurance benefits. In Charles v. UPS National Long Term Disability Plan, 2013 U.S.Dist.LEXIS 164218 (E.D.Pa. November 19, 2013), the court was called upon to decide whether to allow a deposition of the claim adjuster who denied benefits.
A new court ruling is the first to recognize a fiduciary breach claim against a health insurer when misinformation given by its representative cost an employee his benefits.
Federal courts of appeals have limited jurisdiction and may only hear appeals from final judgments. Recently, the 3rd U.S. Circuit Court of Appeals was called upon to decide whether it had jurisdiction to hear an appeal of a benefit case decided under the Employee Retirement Income Security Act (ERISA). Instead of entering judgment outright, the […]
Nearly all 50 state insurance commissioners, including Andrew Boron, the Illinois Insurance Director, have now signed on to the Regulatory Settlement Agreement that requires CIGNA disability insurance companies such as the Life Insurance Company of North America to reconsider denied claims under revised guidelines for: Consideration of Social Security disability awards Evaluation of medical evidence […]