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Court says surveillance an abuse of discretion in disability benefits case

A federal court has ruled that an insurance company’s use of surveillance in denying a claim for disability benefits was an abuse of discretion. In Spooner v. Reliance Standard Life Insurance Co., 2021 WL 2720302 (E.D.N.Y. July 1, 2021), the plaintiff was a former account executive with a media company who stopped working due to chronic pain from fibromyalgia, a sleep disorder and a psychiatric condition.

2012 ERISA Advisory Council hearing on managing disability risks in an environment of individual responsibility

Table of ContentsExecutive Summary:Introduction1. Who Gets the Last Word in the Claim Review Process2. Confusion Regarding Statutes of Limitations3. Treating Doctor Opinions4. Deferential Court Review/Administrative Law Paradigm/Remands of Claims6. DamagesConclusion Executive Summary: I am an experienced practitioner in the field of representing claimants in disability benefit disputes. In my practice, I have encountered a number […]

Court addresses employee benefits law with regard to misrepresentations

One of the most vexing issues in employee benefits law relates to the apparent absence of remedies when harm results from misrepresentations made to employees since Employee Retirement Income Security Act (ERISA) only permits “appropriate equitable relief” (29 U.S.C. § 1132(a)(3)) and bars claims seeking legal remedies such as monetary damages. A leading example of […]

Appeals panel considers insurers rights

In order to prevent a double-recovery of benefits when claimants qualify to receive both Social Security and disability insurance payments, most group insurers include provisions in their policies that reduce the insurance payment by the amount of Social Security benefits received by the claimant. In addition, since Social Security adjudications often follow the disability insurance […]

Courts see more accidental death claims

In addition to disability insurance claims, accidental death claims are the frequent subject of Employee Retirement Income Security Act (ERISA) litigation. One recent ruling was cited by the website, Above the Law, as “A Self-Abuse of Discretion? (Or: The most interesting ERISA opinion ever.)” abovethelaw.com/?s=self-abuse. In Martin v. Hartford Life and Acc.Ins.Co., 2012 U.S.App.LEXIS 7879 […]

Why the Supreme Court’s definition of “civil action” should lead to an overhaul of ERISA civil procedure

Patent law is not ordinarily the place an ERISA practitioner would look to gain insight concerning ERISA civil procedure. However, in a recent patent ruling issued by the Supreme Court, Kappos v. Hyatt, 132 S. Ct. 1690 (April 18, 2012), the Court presented fodder for rethinking the manner in which ERISA cases are adjudicated. Kappos […]

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