bhoffman | September 1, 2010
SIIA, www.siia.org
By Thomas A. Croft, Esq.
I. The Supreme Court Clarifies ERISA Attorney Fee Provision
We have two reasons for reviewing Hardt v. Reliance Standard Life Ins. Co., 130 S. Ct. 2149 (2010). First, it is the latest ERISA decision from the Supreme Court cases define ERISA jurisprudence, they cannot be ignored. Second, the case addresses an [...]
Adam V. Russo | July 9, 2010
The special administrator of the estate of a deceased employee, who was an ERISA plan participant, brought action against the employee’s former employer for breach of fiduciary duty seeking to recover the amount of the employee’s life insurance coverage before his first medical leave of absence, which lapsed when the employee was terminated without notice.
Adam V. Russo | July 9, 2010
Sandra Chronister was employed as a nurse at Baptist Health in Arkansas. In 1995, she was injured in a car accident, and thereafter sought disability benefits under Baptist Health’s long-term disability plan, which was insured and administered by Unum Life Insurance Co. of America. Unum initially granted her application for disability benefits. At Unum’s urging, [...]
Adam V. Russo | January 25, 2010
This is a huge win for the subrogation industry.
The court held that Sereboff, rather than Knudson, controlled in this case. Like in Sereboff, the Plan targeted specific funds for recovery , Cusson’s LTD payments, and identified the specific portion to which Liberty is entitled— the amount of the overpayment while Cusson was receiving benefits under [...]
Adam V. Russo | August 4, 2009
In Iowa Health Systems v. Graham, 2009 U.S. Dist. LEXIS 63544 (C.D. Ill. July 23, 2009), Iowa Health wants the Court to impose a constructive trust or equitable lien over a portion of specifically identifiable funds over which Graham has possession.
Adam V. Russo | July 28, 2009
In Administrative Committee of the Wal-Mart Stores, Inc. v. Gamboa, 479 F.3d 538 (8th Cir. 2007), an ERISA plan administrator brought suit seeking equitable reimbursement from a plan participant who had received a settlement from a tortfeasor. Although the reimbursement provision was contained in an SPD for a health plan, the employer had no formal [...]
Adam V. Russo | May 20, 2009
Estate of Schwing v. Lilly Health Plan, 2009 WL 989114 (3rd Cir. 2009)
The circuit courts continue to address the U.S. Supreme Court’s Glenn decision on the standard of review applicable in ERISA benefits litigation. The more deferential standard applies if the plan document gives the plan decision maker “discretionary” authority to make benefit decisions. In [...]
Adam V. Russo | January 16, 2009
The Supreme Court’s opinion in Black & Decker Disability Plan v. Nord, 538 U.S. 822(2003) did not hold that treating physician opinions can be neglected. This recent Eighth Circuit opinion demonstrates an application of an important piece of the Nord decision – that the administrator must take into account treating physicians’ opinions in reaching its [...]
Adam V. Russo | November 11, 2008
The U.S. District Court in North Dakota recently sorted out conflicting COB provisions of motor vehicle and health coverage. The court ruled that the motor vehicle policy had to pay its maximum benefits before the health plan began paying its benefits. In the North Dakota case, an auto policy restricted benefits to $5,000 in the [...]
Adam V. Russo | May 27, 2008
In two separate cases, courts have found that health plans may refuse to pay benefits if participants or their attorneys refuse to sign reimbursement agreements. Some attorneys refuse to sign such agreements because they believe the plan is not entitled to fulfill reimbursement under applicable law. However, in many cases, the plan then refuses to [...]
