ERISA Archives

Why is the term “Arbitrary and Capricious” So Important in Relation to Disability, Life, Accidental Death, and Medical Benefits from an Employer-Sponsored Benefit Plan?

by Mark Debofsky | Aug 17, 2023 | ERISA

Individuals seeking disability, life, accidental death, or even health benefits under employer-sponsored group benefit plans governed by the Employee Retirement Income Security Act (ERISA) may have their claims thwarted due to what is known as either the “arbitrary and capricious” or “abuse of discretion” standard of judicial review. […]

Benefits Ruling Has ERISA Review Standard Red Flags

by Mark Debofsky | Jul 30, 2023 | ERISA

A recently issued decision from the U.S. Court of Appeals for the Eighth Circuit in McIntyre v. Reliance Standard Life Insurance Co., which was the second ruling on the same case, illustrates how difficult it can be for Employee Retirement Income Security Act governed disability benefit claimants to qualify for benefits when a court applies a deferential standard of judicial review. […]

Hughes v. Northwestern University – The Seventh Circuit Upholds Plaintiffs’ Excessive Fee Claims

by Mark Debofsky | Jun 30, 2023 | ERISA, Retirement Benefits, Uncategorized

The Employee Retirement Income Security Act of 1974 (ERISA)1 governs both retirement and welfare benefits2 (i.e., health, life, and disability benefits) provided by employers to their employees. […]

How to Respond to New Evidence Generated After Submitting an LTD Appeal

by Martina Sherman | Jun 17, 2023 | Disability Benefits, ERISA, Long Term Disability

Proton beam radiation therapy is used to treat various forms of cancer. Rather than using X-rays, proton therapy directs focused energy from protons at tumors. […]

6th Circ. Judge Correctly ID’d ERISA Civil Procedure Conflict

by Mark Debofsky | Jun 11, 2023 | Disability Benefits, ERISA

A recently issued ruling from the U.S. Court of Appeals for the Sixth Circuit, Tranbarger v. Lincoln Life & Annuity Co., addresses the fundamental issue of how courts should be adjudicating Employee Retirement Income Security Act cases.[…]

ERISA Ruling Shows Why Insurers Must Justify Claim Denials

by Mark Debofsky | Jun 1, 2023 | ERISA, Mental Health, Residential Treatment

Employee benefit claimants’ entitlement to a full and fair review of claim denials prior to judicial intervention is embedded in the Employee Retirement Income Security Act.[1] Regulations promulgated by the
U.S. Department of Labor flesh out the specifics as to what constitutes such a review. […]

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