Mealey's ERISA
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January 12, 2024
STD Claim Remanded; Plan Administrator Must Clarify Why Claim Was Denied
TULSA, Okla. — An Oklahoma federal judge remanded a short-term disability (STD) claim to a plan administrator for clarification on the issue of why the plan administrator denied a disability claimant’s second appeal following the termination of his STD benefits.
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January 12, 2024
Disability Claimant Awarded $312,000 For Attorney Fees In Benefits Calculation Dispute
SANTA ANA, Calif. — Following a disability claimant’s successful appeal on a breach of fiduciary duty claim and subsequent settlement with the disability insurer, a California federal judge entered final judgment in the suit and awarded the claimant more than $312,000 in attorney fees after applying a reduction to the number of hours billed by the claimant’s counsel.
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January 11, 2024
District Court Erred In Limiting Award Of LTD Benefits, 9th Circuit Says
PASADENA, Calif. — A district court erred in finding that a claimant was not disabled beyond a certain date because the medical evidence does not show that there was any improvement in the claimant’s heart-related condition, the Ninth Circuit U.S. Court of Appeals said in reversing the lower court’s ruling.
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January 11, 2024
Disability Suit Barred By Utah’s Statute Of Limitations For Insurance Claims
SALT LAKE CITY — A disability claimant’s suit is barred by Utah’s three-year statute of limitations for claims stemming from insurance contracts because the claimant failed to filed suit within three years as required by the statute, a Utah federal judge said, noting that it was not necessary to interpret the policy’s three-year limitations provision based on the claimant’s argument that she never received a final claims denial letter from the insurer.
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January 10, 2024
Parties Wrangle Over ERISA Conclusion Regarding Deferred Compensation Plans
NEW YORK — Parties in a putative class action over deferred compensation are wrangling over a New York federal court’s conclusion that the compensation incentive and equity incentive plans at issue are Employee Retirement Income Security Act plans, with former Morgan Stanley financial advisers arguing in a Jan. 9 filing that “there is no basis for clarification or reconsideration.”
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January 10, 2024
Denying Rehearing, 9th Circuit Lets Fee Denial Under EAJA Stand In ERISA Case
HONOLULU — After a split panel upheld denial of attorney fees and nontaxable costs under the Equal Access to Justice Act (EAJA) in an employee stock ownership plan (ESOP) case, the Ninth Circuit U.S. Court of Appeals denied a petition for rehearing en banc that an amicus curiae organization argued should have been granted because the U.S. Department of Labor (DOL) took “objectively unreasonable” valuation positions.
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January 10, 2024
Evidence Supports Finding That Claimant Is Disabled From Own Occupation
DALLAS — A disability insurer must reinstate a claimant’s long-term disability (LTD) benefits because the preponderance of the evidence supports a finding that the claimant is disabled from performing the material and substantial duties of her own occupation as an insurance agent, a Texas federal judge said in granting the claimant’s motion for judgment on the administrative record.
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January 10, 2024
Disability Claimant Is Entitled To LTD Benefits Based On Evidence, Judge Says
ROANOKE, Va. — A Virginia federal judge awarded a claimant long-term disability (LTD) benefits after determining that the disability insurer abused its discretion in denying the claim because sufficient evidence supports a finding that the claimant was disabled prior to the expiration of the disability plan and fulfilled the plan’s terms before filing a claim for LTD benefits.
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January 09, 2024
Transgender Care Plaintiffs Urge Court Not To Stay Pending Appeal
TACOMA, Wash. — Plaintiffs in a class action opposed a stay of their case on Jan. 8, telling a federal judge in Washington state that they don’t have time to delay critical medical care while their insurer appeals a well-supported decision finding that it cannot violate anti-discrimination laws.
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January 09, 2024
Disability Claimant Awarded More Than $488K In Fees, Costs, Prejudgment Interest
NEW YORK — Following a finding that a disability claimant is owed benefits under a supplemental disability plan, a New York federal judge awarded the claimant more than $488,000 in attorney fees, costs and prejudgment interest after determining that the amounts requested by the claimant were reasonable.
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January 09, 2024
Claimant Failed To Show He Was Disabled For Entirety Of Elimination Period
PASADENA, Calif. — A disability insurer properly denied a claim for long-term disability (LTD) benefits because the claimant failed to meet his burden of showing that he was disabled throughout the entire 90-day elimination period as required by the policy and because the record contains no medical evidence contradicting the date for the onset of disability, the Ninth Circuit U.S. Court of Appeals said in affirming a district court’s judgment in favor of the disability insurer.
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January 09, 2024
Disability Pension Plan Did Not Act Arbitrarily In Setting Onset Date, 6th Circuit Says
CINCINNATI — A district court did not err in ruling in favor of a disability pension plan trust on the issue of a claimant’s disability onset date because the plan trust correctly determined the disability onset date based on the applicable plan terms, the Sixth Circuit U.S. Court of Appeals said.
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January 09, 2024
$3.25M Settlement Gets Initial OK In ERISA Row Over Hospital System’s Plans
BALTIMORE — A Maryland federal judge has granted preliminary approval to a $3.25 million class settlement that would resolve an Employee Retirement Income Security Act suit over management of a Maryland hospital system’s retirement plans, including use of the GoalMaker asset allocation service as the default investment option.
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January 09, 2024
Transfer Of Disability Suit To West Virginia Is Appropriate, Judge Says
COLUMBUS, Ohio — A disability claimant’s suit must be transferred from Ohio federal court to West Virginia federal court because the claimant failed to show that the disability insurer’s minimum contacts are sufficient for an Ohio federal court to exercise personal jurisdiction over the insurer, an Ohio federal judge said in granting the insurer’s motion to transfer venue.
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January 08, 2024
Proposed Bar Order Leads Judge To Deny Approval Of $4.5M ERISA Settlement
FLORENCE, S.C. — Saying in part that “that the proposed bar order is prejudicial to the” objecting defendants, a South Carolina federal judge on Jan. 5 denied without prejudice a motion proposing a $4.5 million class settlement of claims against Aon Investments USA Inc. in a suit over a retirement plan’s use of proprietary collective investment trusts (CITs.)
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January 08, 2024
Judge Won’t Dismiss Suit Challenging State’s New Rules Concerning ESG Factors
JEFFERSON CITY, Mo. — Denying dismissal in a suit challenging new Missouri rules that a trade association says require “a state-authored script” for “incorporating a social or nonfinancial objective into investment advice,” a Missouri federal judge on Jan. 5 rejected state officials’ arguments that Securities Industry and Financial Markets Association (SIFMA) lacks associational standing and failed to state a claim.
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January 08, 2024
DOL, Defendants Make Opening Statements In ERISA Suit Over ESOP Deal
PHOENIX — In written opening statements filed in advance of a scheduled bench trial in Arizona federal court, the U.S. Department of Labor (DOL) and leaders of a recreational vehicle company outline markedly different views of the employee stock ownership plan (ESOP) deal that drew a legal challenge from the DOL under the Employee Retirement Income Security Act.
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January 08, 2024
11th Circuit Affirms Dismissal Of Dermatologist’s Case For Lack Of ERISA Standing
ATLANTA — Saying in an unpublished per curiam opinion that a dermatologist “abandoned” any challenge to the dispositive holding in the challenged dismissal order, an 11th Circuit U.S. Court of Appeals panel affirmed the lower court’s ruling in the suit concerning a patient’s purported assignments of benefits.
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January 08, 2024
Plaintiff Suggests Narrowing Proposed Class In ERISA Suit Over ESG Factors
FORT WORTH, Texas — In a reply brief in Texas federal court, an American Airlines pilot challenging retirement plans’ use of strategies and funds purportedly incorporating environmental, social and governance (ESG) considerations proposed narrowing his proposed class to exclude the funds theory.
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January 08, 2024
Employer Asks 3rd Circuit To Uphold Dismissal In ERISA Row Over Drug Rebates
NEWARK, N.J. — Urging the Third Circuit U.S. Court of Appeals to affirm dismissal of an Employee Retirement Income Security Act suit, an employer argues primarily that the trial court correctly ruled that former participants in its self-funded health care plan who sued over approximately $65 million in drug rebates didn’t allege an injury in fact.
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January 04, 2024
Citing Previous Ruling,11th Circuit Affirms Dismissal Of ERISA Assignment Row
ATLANTA — Citing a ruling the 11th Circuit U.S. Court of Appeals issued in a different case brought by the same dermatologist, a panel affirmed dismissal of her suit and the “finding that the assignments upon which [she] relied did not include sufficiently explicit language to transfer the right to bring non-payment, statutory penalty suits under” the Employee Retirement Income Security Act.
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January 04, 2024
10th Circuit Won’t Stay Mandate In PBM Law Row For Planned Certiorari Bid
DENVER — Without explanation, a 10th Circuit U.S. Court of Appeals panel denied an opposed motion in which Oklahoma regulators cited their planned certiorari petition in seeking a stay of the court’s mandate regarding an Oklahoma law pertaining to pharmaceutical benefit managers (PBMs) that the panel ruled partially preempted by the Employee Retirement Income Security Act and Medicare Part D.
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January 04, 2024
$500,000 Settlement Gets Final OK In ERISA Record-Keeping Fees Case
SPRINGFIELD, Mass. — A $500,000 class settlement of an Employee Retirement Income Security Act suit over allegedly excessive record-keeping fees for a health system’s 403(b) defined contribution pension plan won final approval in Massachusetts federal court, with class counsel awarded a third of that amount for attorney fees.
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January 03, 2024
In Amicus Brief, DOL Supports New Trial In ERISA Imprudence Case
NEW YORK — In an amicus curiae brief echoing the key contention made by Yale University 403(b) retirement plan participants, Acting U.S. Department of Labor (DOL) Secretary Julie A. Su urges the Second Circuit U.S. Court of Appeals to order a new trial in the Employee Retirement Income Security Act class action because the jury instructions erroneously used a “could have” rather than a “would have” standard.
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January 03, 2024
Citing APA, Amicus Groups Urge Review Of 10th Circuit Health Benefits Ruling
WASHINGTON, D.C. — The U.S. Supreme Court should review a ruling that “significantly alter[ed] claims administrators’ obligations in health-benefits denial cases” by adopting “a revisionist interpretation” of U.S. Department of Labor (DOL) regulations, the ERISA Industry Committee (ERIC) and The Chamber of Commerce of the United States of America say in a Jan. 2 joint amicus curiae brief.