Court Rejects Third Party Administrator's Demurrer to Insurance Bad Faith Claim Based on Plaintiffs' Theory of Joint Venture Liability

Posted in: Bad Faith, Breach of Contract, Case Updates, Disability Insurance, Disability Insurance News, Insurance Bad Faith, Insurance Litigation Blog, Non-ERISA January 24, 2018

Implied in every insurance contract is a promise of “good faith and fair dealing,” which means that the insurer must not take unreasonable steps to prevent an insured’s right to receive benefits under the policy. To comply with its promise …

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Exhaustion of Administrative Remedies in ERISA: The Potential Death Knell of a Disability, Life or Health Insurance Claim

Posted in: Disability Insurance News, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation January 06, 2018

The Employee Retirement Income Security Act of 1974, or ERISA, establishes protections for most employee benefits offered through employer-sponsored benefit plans. ERISA requires that the plan and claims administrators adhere to certain internal procedures, often referred to as “administrative remedies,” …

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Cohorst v. Anthem: When Does Waiver Apply under ERISA?

Posted in: Disability Insurance News, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation December 26, 2017

The Employee Retirement Income Security Act of 1974, or ERISA, governs most employer-sponsored benefit plans.  ERISA establishes protections for employees in the administration of their employer-sponsored benefits, requiring that the administrator adhere to certain requirements when determining a plan participant’s …

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When the Clock is Ticking: The Interplay of the Contractual Limitations Period and the Statute of Limitations in a Disability Insurance Case

Posted in: Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation, Statute of Limitations December 26, 2017

The Employee Retirement Income Security Act of 1974, otherwise known as ERISA, governs most employer-sponsored benefit plans, including short and long-term disability benefits, life benefits, accidental death and dismemberment benefits and others.  ERISA was enacted to protect employer-sponsored benefits provided …

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The Hartford Agrees to Purchase Aetna's Group Disability Insurance and Group Life Insurance Business

Posted in: Disability Insurance, Disability Insurance News, ERISA, Group Plans, Life Insurance, News Blog November 08, 2017

In a deal between two of the country’s largest disability insurers, The Hartford agreed to purchase Aetna Life Insurance Company’s group life insurance and disability insurance business for $1.45 billion. After the purchase, which is expected to close before the …

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Plan Administrators Cannot Violate their Fiduciary Duties by Failing to Provide Proper Notice of Policy Amendments; ERISA Plan Exclusions/Limits May Not be Enforceable

Posted in: Disability Insurance, Disability Insurance News, ERISA, Group Plans, Health Insurance, Insurance Litigation Blog, News Blog September 28, 2017

Summary Plan Descriptions (“SPD”) under ERISA are required to be given to plan participants, and they provide plan participants with the most important summary of plan terms they need to know regarding their ERISA governed plans.  ERISA requires SPDs to …

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Ninth Circuit Grants a Small Reprieve to the Abuse of Discretion Standard of Review, Ruling That Discretionary Language Provisions in Self-Funded ERISA Will Apply

Posted in: Abuse of Discretion, De Novo Review, Disability Insurance News, ERISA, Insurance Litigation Blog, Standard of Review August 24, 2017

When litigating ERISA-governed short-term disability, long-term disability, life and medical insurance claims, a major consideration is which “standard of review” will apply to the Court’s review of the insurer’s decision – abuse of discretion or de novo.  The de novo …

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