In A. Griffin v. United Healthcare Services, Inc., No. 23-13429, 2024 WL 1855456 (11th Cir. Apr. 29, 2024), the Eleventh Circuit affirmed the dismissal of Dr. Griffin’s lawsuit seeking damages under 29 U.S.C. § 1132(c)(1) against United Healthcare Services, Inc. for United’s failure to provide her with certain documents connected to her treatment of two patients. Dr. Griffin argued that she has the right to sue under ERISA based on an assignment of “rights and benefits” that she received from her patients. The Eleventh Circuit held that a patient does not transfer the right to assert ERISA cla ..read more

In Morales v. CoAdvantage Corp., No. 6:24-cv-117-JA-DCI, 2024 WL 1678250 (M.D. Fla. Apr. 18, 2024), Florida Middle District Judge John Antoon, II granted in part Defendants’ motions to dismiss finding that although Plaintiffs’ complaint had not adequately stated claims for breach of fiduciary duty under ERISA Section 1132(a)(3), that the Count could be rewritten and brought in the alternative to the Section 1132(a)(1)(B) claim for benefits. The Complaint alleges that Plaintiffs are the primary beneficiaries to a group life insurance plan insured by Unum in which the decedent was a participant ..read more

In Appvion, Inc. Ret. Sav. & Emp. Stock Ownership Plan by & through Lyon v. Buth, No. 23-1073, __F.4th__, 2024 WL 1739032 (7th Cir. Apr. 23, 2024), Plaintiff-Appellant is the Appvion, Inc. Savings and Employee Stock Ownership Plan, for which Grant Lyon was authorized to act on its behalf by a bankruptcy court. Following Appvion, Inc.’s declaration of bankruptcy in 2017, Lyon brought many claims—ERISA, federal securities law, and various state laws—against many defendants related to his theory that the defendants fraudulently inflated the company’s price in 2001, when it was sold to its ..read more

In Wongsang v. Reliance Standard Ins. Co., No. 1:23-CV-1 (RDA/IDD), 2024 WL 1559292 (E.D. Va. Apr. 10, 2024), Virginia Eastern District Judge Rossie D. Alston, Jr. granted Plaintiff’s motion for summary judgment finding Plaintiff remained totally disabled from any occupation within the meaning of the long-term disability (“LTD”) policy. In 2016, Plaintiff first sought, and Reliance awarded, short-term disability benefits through the maximum benefit period for disability due to symptoms of arthralgia, back pain, neck pain from cervical herniated discs, fibromyalgia, chronic fatigue, Epstein Bar ..read more

In Roeder v. Guardian Life Ins. Co., No. 22-56226, 2024 WL 1612256 (9th Cir. Apr. 15, 2024), Plaintiff-Appellant Jacqueline Roeder appealed the district court’s de novo review of Guardian Life Insurance Company’s denial of her claim for long-term disability benefits under a policy governed by ERISA on the basis of the policy’s pre-existing condition exclusion. The Ninth Circuit found no errors of law or clearly erroneous factual findings and affirmed the judgment of the district court. Roeder became disabled from work due to severe neck pain from a degenerative cervical spine condition. Becaus ..read more

In Perkins v. United Surgical Partners International, Inc., et al., No. 23-10375, 2024 WL 1574342 (5th Cir. Apr. 11, 2024), Plaintiffs are participants of a defined contribution plan established by United Surgical Partners International, Inc. They sued United and other Plan fiduciaries, alleging that the defendants violated their fiduciary duties under ERISA in the management of the plan’s investments and costs. The district court dismissed the Amended Complaint under Rule 12(b)(6) for failure to state a claim. Considering the Supreme Court’s decision in Hughes v. Northwestern University, 595 ..read more

In Ryan S. v. UnitedHealth Grp., Inc., No. 22-55761, __F.4th__, 2024 WL 1561668 (9th Cir. Apr. 11, 2024), Plaintiff-Appellant Ryan S. brought a putative class action against Defendant-Appellee UnitedHealth Group, Inc. and its subsidiaries alleging that the Defendants violated the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (“Parity Act”), 29 U.S.C. § 1185a, and their ERISA fiduciary duties by applying a more stringent review process for outpatient, out-of-network mental health and substance use disorder (MH/SUD) treatment than to comparable medical/su ..read more

In Rogers v. Unum Life Insurance Company of America, et al., No. 22-CV-11399-AK, 2024 WL 1466728 (D. Mass. Mar. 31, 2024), Massachusetts District Judge Angel Kelley denied both Plaintiff and Defendant Unum’s Motions for Summary Judgment, finding that the court required more information to determine whether Unum’s decision to deny Plaintiff’s long-term disability (LTD) claim was arbitrary and capricious, and directing Unum to prepare an amended final determination letter. Plaintiff first sought and Unum awarded short-term disability (STD) benefits through the 26-week maximum benefit period for ..read more

In E.L. v. Hartford Life and Accident Insurance Company, No. 22-CV-00050-PCP, 2024 WL 1336463 (N.D. Cal. Mar. 27, 2024), California Northern District Judge P. Casey Pitts granted Plaintiff’s Motion for Judgment in part finding that Plaintiff demonstrated total disability from her own occupation. The Court denied Plaintiff’s request to submit extrinsic evidence from her Social Security disability claim, finding that the circumstances did not clearly establish that additional evidence was necessary to conduct an adequate de novo review. Plaintiff was a resident of Campbell, California and employ ..read more

In Khesin v. Hartford Life & Accident Insurance Company, No. 22-1766, 2024 WL 1404576 (2d Cir. Apr. 2, 2024), Plaintiff-Appellant Daniel Khesin appealed the district court’s judgment in favor of Hartford Life & Accident Insurance Company on his claims for long-term disability (“LTD”) and life-waiver-of-premium (“LWOP”) benefits. Khesin sought LTD and LWOP benefits after his condition of neuromyelitis optica rendered him unable to work. Hartford paid Khesin two years of LTD benefits and denied benefits thereafter. Hartford never approved Khesin’s LWOP claim. Reviewing de novo Khesin’s c ..read more