A recent ruling from a federal court in Alabama – Rosen v. Provident Life and Accident Insur. Co., 2015 WL 260839 (N.D.Ala. January 21, 2015) addressed a controversial issue involving ERISA preemption. Typically, ERISA is implicated only where an employer sponsors a retirement plan or offers group coverage to its employees for disability, life, or […]
DeBofsky, Sherman & Casciari recently won the case of Warner v. Unum Life Ins. Co., No. 12 C 02782, 2014 U.S. Dist. LEXIS 178765 (N.D. Ill. Dec. 31, 2014), where the district court granted summary judgment for the plaintiff, ruling that Unum Life Insurance Company (“Unum”) acted arbitrarily and capriciously by disregarding the results of […]
Setting aside money for retirement is just one step towards future financial security. In addition to funding retirement savings, a long-term care insurance policy may provide additional protection in the event of debilitating illness. This form of insurance is designed to afford protection against the expenses of long-term care in the home or in a […]
On December 1, 2014, the U.S. Court of Appeals heard oral argument in the case of Mary C. Fontaine v. Metropolitan Life Insurance Company. The issue before the court was whether an Illinois insurance regulation banning discretionary clauses in health and disability insurance policies survives ERISA preemption claims. The lower court ruled in Fontaine’s favor. […]
In evaluating occupational disability claims, insurers distinguish between the insured’s job and their occupation. If an employee cannot perform their job, they may still be denied disability insurance benefits if they remain capable of performing their occupation as it is generally performed in the national economy. Polnicky v. Liberty Life Assur.Co. of Boston, 2014 WL […]
A recent ruling from a federal court in Ohio discusses the interplay between the “deemed exhausted” provision of the ERISA claim regulations – 29 C.F.R. Sec. 2560.503-1(l) – and claim administrators’ requests to “toll” the clock on when claim appeals have to be decided. In Gay v. National Rural Electric Cooperative Association Group Benefits Program, 2014 […]
Establishing which court will have jurisdiction over an ERISA-governed claim is the first step in litigation. There are many factors that can influence the outcome of a lawsuit, or may even determine whether a case can even be brought. In ERISA cases, often the first issue that needs to be resolved is where the lawsuit […]
The nation’s highest court has agreed to hear a case that considers when pension plan participants under ERISA can sue their plan administrators for mismanagement, even years after the alleged misconduct took place. It is the first case the Supreme Court will hear regarding excessive 401(k) fees. The Employee Retirement Income Security Act of 1974 […]
A ruling won by DeBofsky, Sherman & Casciari, Curtis v. Hartford Life & Acc.Ins.Co., 2014 WL 485233 (N.D.Ill. August 20, 2014) illustrates the importance of considering the combined impact of more than one medical condition in determining disability.
A recent DeBofsky, Sherman & Casciari victory, Cheney v. Standard Ins.Co., 2014 WL 4259861 (N.D.Ill. August 28, 2014) illustrates the concept of being disabled while still working and thus qualifying for disability insurance benefits. The plaintiff, Carole Cheney, was a non-equity partner at the law firm of Kirkland & Ellis, LLP who specialized in appellate […]
An insurer recently learned a hard lesson in how not to terminate disability benefits in Bertelsen v. Hartford Life Ins.Co., 2014 U.S.Dist.LEXIS 19225 (E.D.Cal. Feb. 14, 2014).
There, the plaintiff, Karen Bertelsen, worked as an engineering document control manager until she became disabled in 2008 on account of back pain caused by degenerative disk disease of the lumbar spine.
SCOTUS will soon decide on whether ERISA trumps state health care database laws. For the first time in almost ten years, the Supreme Court of the United States (SCOTUS) has agreed to hear a case involving an Employee Retirement Income Security Act of 1973 (ERISA) claim. The case calls into question whether or not a […]