DeBofsky Law obtains favorable court ruling on ERISA standard of review
DeBofsky & Associates recently obtained a favorable court ruling on the standard of review
Articles
Updates on the latest in benefits news and practical pointers for your benefits-related issues.
MetLife’s ‘cookie-cutter’ diagnosis slammed
It is typical that group disability insurance policies limit the duration of disability payments for psychiatric conditions. However, in Reid v. Metropolitan Life Ins. Co., 2013 U.S.Dist.LEXIS 66755 (N.D.Ga. March 29, 2013), an insurer’s reliance on reviewing doctors to evaluate a claim failed to convince a court that the limitation was applicable in the face […]
DeBofsky Law wins court ruling on ERISA standard of review
DeBofsky & Associates recently won a significant court ruling on the ERISA standard of review.
Court gives insurer another bite at the apple
Despite advances in medical science, many medical conditions such as tinnitus – a ringing or buzzing in the ears that afflicts millions of Americans – cannot be objectively diagnosed or verified. The case of Miles v. Principal Life Ins.Co., 2013 U.S.App.LEXIS 13065 (2nd Cir. June 26, 2013), which involved a partner in a major law […]
Equity Provides a Way to Right a Wrong
If a health insurer mistakenly advises a patient that a surgical procedure is covered by its policy – and in reliance on that advice, the patient proceeds with the surgery, can the patient recoup the expenses incurred in undergoing the procedure from the insurance company if the insurer maintains that its prior advice was mistaken?
Court rejects claim that vitamin supplements are a medical treatment
The Seventh Circuit Court of Appeals recently ruled that vitamin supplements do not qualify as medical treatment for purposes of a disability claim.
Florida case offers lesson on ERISA, good-faith duties and fair dealing
The main lesson taught by a recent federal court ruling issued in Florida, Wilson v. Walgreen Income Protection Plan, 2013 U.S.Dist.LEXIS 62021 (M.D.Fla. April 29, 2013), is that the Employee Retirement Income Security Act (ERISA) imposes duties of good faith and fair dealing that preclude deceptive and unreasonable claim handling tactics. The plaintiff, Deborah Wilson, […]
High court looks at use of ‘common-fund doctrine’ for personal-injury settlements
The U.S. Supreme Court recently issued a significant ruling on the rights of health benefit plans to recoup payments out of personal-injury settlements. U.S. Airways Inc. v. McCutchen, 2013 U.S.LEXIS 3156 (April 16, 2013) involved James McCutchen, an employee of US Airways and a participant in that organization’s health benefits plan, who was severely injured […]
Federal court rules that showing up for work is a key to doing the job
Woody Allen is quoted as saying that 80 percent of life is just showing up. That was the lesson taught by Neaton v. Hartford Life and Acc.Ins.Co., 2013 U.S.App.LEXIS 5814 (6th Cir. March 21, 2013)(non-precedential) which focused on James Neaton’s absences from work while recovering from multiple surgeries. Neaton, who worked as a debt collector, […]
Disability Pension Blocked for Working Man
The phrase “total and permanent disability” can be subject to multiple meanings, as a recent ruling from the 7th U.S. Circuit Court of Appeals pointed out. In Tompkins v. Central Laborers’ Pension Fund, 2013 U.S.App.LEXIS 5161 (7th Cir. March 13, 2013), the appellate court determined that, even in the face of ambiguity, a pension plan administrator offered an interpretation of that phrase which was reasonable and within the scope of his/her discretionary authority when interpreting the plan.
7th Circuit Addresses Lump-Sum Pension Distribution Question
Lump-sum pension distributions are frequently the subject of litigation and the 7th U.S. Circuit Court of Appeals addressed such a case in Dennison v. MONY Life Retirement Income Security Plan for Employees, 2013 U.S.App.LEXIS 4651 (7th Cir. March 6, 2013). The named plaintiff in a class action, John Dennison, was employed by MONY (Mutual of […]
Federal appellate court reinstates claim in ERISA dispute
The scope of remedies available under Employee Retirement Income Security Act due to an employer or plan administrator’s breach of fiduciary duty is undergoing a dramatic transformation in the wake of a recent Supreme Court ruling. The most recent example is Gearlds v. Entergy Services Inc., 2013 U.S.App.LEXIS 3831 (5th Cir. Feb. 19, 2013). That […]