In Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989), the U.S. Supreme Court ruled that benefit claims under the ERISA law should be evaluated under principles of trust law, which allows discretionary authority to be vested in trustees to determine eligibility to receive benefits and to interpret the plan documents. At the […]
A recent ruling from the federal court in Atlanta, Johnson v. Metropolitan Life Ins.Co., 2008 U.S.Dist.LEXIS 42944 (N.D.Ga. May 30, 2008), offered a very interesting and thorough analysis of a disability benefit dispute. In Johnson, the plaintiff, who had worked for Cingular for more than 13 years as a ”field coordinator, global accounts,” suffered from […]
Group disability benefits are typically offset by both Social Security disability benefits and by awards of workers’ compensation. In Alloway v. ReliaStar Life Ins.Co., 2008 U.S.Dist.LEXIS 34853 (C.D.Cal. April 28, 2008), the district court took a fresh look at workers’ compensation offsets, and the result proved beneficial to claimants. Alloway was a class action consisting […]
A decision by the U.S. District Court for the District of Connecticut prevents the review of a doctor’s report in a disability case.
Employee benefits issues have occupied the courts recently and will continue to do so. Court decisions have reflected the most prevalent current economic issues, and also have addressed issues that will be decisive in the upcoming national election. For example, the debate over national health care has resulted in conflicting decisions relating to local initiatives […]
In Caplan v. CNA Financial Corp., 2008 U.S.Dist.LEXIS 28290 (N.D.Cal. April 4), David Caplan, who worked for CNA Financial supervising workers’ compensation claims, suffered a neck injury, which caused severe pain, and spasms that significantly interfered with his ability to work at a computer, his primary job function. Initially, Caplan tried to deal with his […]
A federal district court in Illinois recently invalidated an insurance company’s offset of dependent Social Security disability benefits.
Two significant rulings issued days apart upheld the authority of state departments of insurance to prohibit life and disability insurers from including discretionary clauses in their policies that would have the effect of triggering an arbitrary and capricious standard of review under the ERISA law. At issue was the adoption by several states of a […]
Welch v. Unum Life Ins. Co. of America, 2007 U.S.Dist.LEXIS 91796 (D.Kansas Dec. 13, 2007), was before the court on remand from the 10th U.S. Circuit Court of Appeals (Welch v. Unum Life Insur. Co. of America , 382 F.3d 1078 (10th Cir. 2004), where the appellate court ruled that consideration had to be given […]
After a district court awarded benefits to the plaintiff, the insurer successfully appealed to the 10th U.S. Circuit Court of Appeals, which issued a ruling narrowly constraining the scope of consideration of ERISA claims under the de novo standard of adjudication. Jewell v. Life Ins.Co. of North America, 2007 U.S.App.LEXIS 27832 (Nov. 30, 2007). The […]
Kaelin v. Tenet Employee Benefit Plan, 2007 U.S.Dist.LEXIS 86063 (E.D.Pa. Nov. 21), has had a long and tortured history. Before this final ruling, the district court had issued two earlier rulings: Kaelin v. Tenet Employee Benefit Plan, 405 F. Supp. 2d 562 (E.D. Pa. 2005), and Kaelin v. Tenet Employee Benefit Plan, 2006 U.S.Dist.LEXIS 14858 […]