Entries by J.J. Conway

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The Trend of ERISA Class Actions Against Universities Picks Up Strength as Cornell Workers Class Is Certified

On January 22nd, 2019, a federal district judge certified a class of at least 28,000 participants and beneficiaries of the Cornell University Retirement Plan, consisting of the Employees of the Endowed Colleges at Ithaca Plan and the Cornell University Tax Deferred Annuity Plan, in Cunningham et al. v. Cornell University et al., No. 1:16-cv-06525 (S.D.N.Y., […]

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Federal Court Details Reliance Standard’s Long History Of Abuse In The Handling Of ERISA Long Term Disability Claims

A federal district judge in Mississippi undertook the painstaking steps of collecting and documenting Reliance Standard’s long history of abusive claims practices in disability claims.   The expansive decision of Nichols v. Reliance Standard Life Ins. Co., No. 3:17-CV-42-CWR-FKB, 2018 WL 3213618 (S.D. Miss., June 29, 2018), contains hundreds of citations of cases where reviewing courts […]

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Sixth Circuit Kills ERISA LTD Claim for Failing to File a Benefits Application

The typical scenario in a benefits claim works something like this:  An employee becomes ill or injured.  An employee takes a medical leave of absence.  If the employer has sponsored a disability program, a claim for benefits is filed.  If there is a short-term disability plan, that benefit program may or may not be ERISA-qualified.  […]

Idaho Federal Court Rules That Medical Provider’s Appeal On Patient’s Behalf Can Serve To Exhaust Administrative Remedies Under ERISA

The United States District Court for the District of Idaho has ruled that a medical provider, acting pursuant to a pretreatment authorization and assignment of rights, may appeal an adverse benefit determination on the patient’s behalf for purposes of exhaustion under ERISA.   In Abdilnour v. Blue Cross of Idaho Health Service Inc., Case No. 17-00412 […]

ERISA Long-Term Disability Claims: Court Allows Standard Of Review Challenge For Improper Discretionary Delegation

The standard of review in ERISA cases can have a considerable impact on the outcome of a long-term disability claim. As the Supreme Court observed in Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101, 115 (1989), “the validity of a claim to benefits under an ERISA plan is likely to turn on the interpretation of terms in […]

2018: The Coming ERISA Disability Regulations and A Bit of Good News for Claimants

Insurance companies administering ERISA long-term disability claims may be facing new rules.  In 2012 the U.S. Department of Labor’s ERISA Advisory Council undertook a study on issues relating to managing disability claims in the ERISA administrative review context. The Advisory Council recommended that the USDOL review the current claims regulation and recommend specific updates and […]

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A Lawyer’s Tough Talk on Long Term Disability Insurance Claims

In twenty years of handling employee benefit disputes, I have made a few observations of the ways to keep a long-term disability insurance claim in “approved status” or “open” as insurance companies say. A disability claimant’s medical file should include accurate and documented history of disability and should always be up to date. A disability […]