David Rossmiller – who normally runs, as I have noted previously, from ERISA cases as from a basket of snakes – and Day on Torts both have posts today on the Fourth Circuit’s decision upholding an administrator’s denial of accidental death benefits under an ERISA governed plan where the deceased died in an automobile accident
Benefit Litigation
The Supreme Court, Abatie and Conflicts of Interest
I have written extensively before – including both here and here -about Abatie v. Alta Health, the Ninth Circuit’s relatively recent decision revising that circuit’s approach to structural conflicts of interest and the effect such conflicts should have on the standard of review in denial of benefit cases. The Ninth Circuit’s new rule, I…
Recoupments and Set Offs Under ERISA Plans
By Stephen Rosenberg on
Here’s a very interesting decision, Northcutt v. General Motors Hourly-Rate Employees Pension Plan, out of the 7th Circuit, upholding the right of administrators to rely on recoupment language in a plan to set off a lump sum social security payment received by a beneficiary against on-going payment obligations to that beneficiary that would otherwise…
Employee Welfare Benefit Plans and the Small Employer
Preemption is a tough defense to get around, particularly in the First Circuit, where it is taken quite seriously and numerous decisions expressly declare particular state law causes of action to be preempted by ERISA. One clever response to this problem, at least when the facts will allow the argument, is to try to sidestep…
Preemption, Appellate Review and Plan Interpretation in the First Circuit
By Stephen Rosenberg on
The First Circuit released its most recent ERISA decision, Carrasquillo v. Pharmacia Corp., a few days ago. Of interest in the decision, the court notes the standards that the appellate court should apply in reviewing a district court’s entry of summary judgment when the arbitrary and capricious standard applies. The court reiterated that while…
What Standard of Review Applies to a Claim That Was Never Reviewed?
By Stephen Rosenberg on
Posted in Benefit Litigation, Standard of Review
We have talked a lot about the different standards of review that courts should apply when reviewing an administrator’s decision concerning a claim for benefits under ERISA. But what about if the administrator never applied any review at all before the dispute ended up in the courts? Courts differ on whether this should change the…
More from the Academy on ERISA Standards of Review and the Conflicted Decision Maker
By Stephen Rosenberg on
Posted in Benefit Litigation, Standard of Review
Allright, here’s another law review article, this time out of the Oklahoma Law Review by way of Workplace Prof, complaining about the standards of review currently applied by the courts to ERISA benefit denial cases. Although I haven’t yet read it – I just finished Langbein’s on the same topic, and I’m not ready…
The Unum Provident Problem
I have spent some time recently reading a draft version of Yale Professor John Langbein’s article, Trust Law as Regulatory Law: The Unum/Provident Scandal and Judicial Review of Benefit Denials under ERISA. For those of you who have more socially redeeming hobbies (like mowing the lawn, watching paint dry, pretty much just about anything I…
Abatie, Part II
By Stephen Rosenberg on
I don’t want to leave the impression that the Ninth Circuit’s decision in Abatie is a wacky or fringe decision, or that I think that myself. Far from it. The new rule it announces for that circuit on the effect of structural conflicts is certainly well within the margins of current mainstream jurisprudence on the…
First vs Ninth, and Structural Conflicts of Interest in ERISA Litigation
By Stephen Rosenberg on
A frequent correspondent, even though he normally runs from ERISA cases as though he ‘d been handed a basket full of snakes, forwarded me the Ninth Circuit’s decision from earlier this week in Abatie v Alta Health and Life Insurance. Fascinating opinion. I could write an article or even a book on the…