In Coast Specialty Surgery Ctr., Inc. v. Blue Cross of California, No. 22-55717, __F.4th__, 2024 WL 105317 (9th Cir. Jan. 10, 2024), the Ninth Circuit held that Plaintiff-Appellant South Coast Specialty Surgery Center, Inc. had the authority to file a lawsuit seeking payment of plan benefits under ERISA § 502(a) by virtue of valid assignment of benefits from its patients. The district court dismissed South Coast’s ERISA claims upon determining that South Coast’s Assignment of Benefits form conveyed only the right to receive direct payment from Anthem, not the right to sue, and that Ninth Circu ..read more

In Ramos v. Schlumberger Group Welfare Benefits Plan, No. 22-CV-0061-CVE-JFJ, 2023 WL 8869239 (N.D. Okla. Dec. 22, 2023), Oklahoma Northern District Judge Claire V. Eagan remanded Plaintiff’s claim for short-term disability (“STD”) benefits to the Plan Administrator to address procedural errors and provide adequate factual findings and explanation of the grounds for its decision on Plaintiff’s second voluntary appeal. Plaintiff, an environmental specialist at Schlumberger, stopped working due to major depressive disorder with suicidal ideation and submitted a claim to claims administrator, Cig ..read more

In Huff v. BP Corporation North America, Inc. et al., No. 23-5022, 2023 WL 8802698 (10th Cir. Dec. 20, 2023), the Tenth Circuit considered whether a retiree’s state law claims against his former employer, which are premised on the increase of his post-retirement monthly life insurance premiums, are preempted by ERISA. The court found that the claims are related to a company-sponsored employee benefit plan and are preempted by ERISA. Plaintiff Huff worked for BP until he retired in 1998. He was enrolled in the BP Group Universal Life Plan, which provides group universal term life insurance bene ..read more

In Needham v. Chubb Corp., et al., No. 22-1829, 2023 WL 8711814 (3d Cir. Dec. 18, 2023), the Third Circuit considered the ERISA claims brought by Plaintiffs Needham and Dowman, who after working at the Halifax Plantation’s golf club for twenty years argued they were wrongfully denied participation in employee benefit plans offered by Chubb Corporation, a company affiliated with Plaintiffs’ employer, Halifax Plantation Golf Management, Inc. On de novo review, the Third Circuit held that the Chubb’s Retirement Administration Committee did not act arbitrarily or capriciously when it denied Plaint ..read more

In Atanuspour v. Reliance Standard Life Insurance Company, No. 22-55765, 2023 WL 8663879 (9th Cir. Dec. 15, 2023), a short unpublished memorandum disposition, the Ninth Circuit affirmed the district court’s judgment in favor of Defendant Reliance Standard Life Insurance Company in this action for recovery of long-term disability (“LTD”) benefits under ERISA. In reviewing for clear error, the court determined that the district court did not clearly err in determining that Plaintiff’s disability onset date did not start until towards the end of the LTD policy’s elimination period. The Reliance S ..read more

Turner v. Allstate Insurance Company, No. 23-10187, 2023 WL 8667011 (11th Cir. Dec. 15, 2023) (Before: Jordan, Jill Pryor, and Branch, Circuit Judges). In a per curiam opinion, the Eleventh Circuit affirmed the summary judgment order in favor of Allstate Insurance Company in this lawsuit challenging its decision to stop paying life insurance premiums for a group of retirees. Judge Emily Marks, the district court judge who issued the summary judgment order, had owned Allstate stock while the case was pending before her and should have recused. The parties were informed of this conflict just day ..read more

In D.L. Markham DDS, MSD, Inc. 401(K) Plan v. Variable Annuity Life Ins. Co., No. 22-20540, __F.4th__, 2023 WL 8642231 (5th Cir. Dec. 14, 2023), Plaintiffs D.L. Markham DDS, MSD, Inc. (“Markham”) and D.L. Markham DDS, MSD, Inc. 401(k) Plan appealed the district court’s dismissal of their ERISA breach of fiduciary and prohibited transaction claims against Variable Annuity Life Insurance Company (“VALIC”), an insurance corporation that specializes in tax-qualified retirement plans. The Fifth Circuit affirmed the district court’s decision, holding that (1) the collection of a contractually predet ..read more

In Smith v. Prudential Ins. Co. of Am., No. 23-1168, __F.4th__, 2023 WL 8446510 (1st Cir. Dec. 6, 2023), Plaintiff brought suit against his long-term disability (LTD) insurer, Prudential Insurance Company of America, alleging breach of fiduciary duty after Prudential terminated his LTD benefits. The United States District Court for the District of Rhode Island granted Prudential’s motion for summary judgment, and Plaintiff appealed. The First Circuit Court of Appeals affirmed the decision on two of the three legal arguments but certified to the Rhode Island Supreme Court Plaintiff’s public pol ..read more

In Ian C. v. UnitedHealthcare Ins. Co., No. 22-4082, __F.4th__, 2023 WL 8408199 (10th Cir. Dec. 5, 2023), the Tenth Circuit determined that UnitedHealthcare Insurance Company’s (United) denial of residential treatment to a teenager, A.C., who suffered from mental health and substance-abuse problems was an abuse of discretion under ERISA because United failed to address his substance abuse as an independent ground for coverage. The court reversed the district court’s finding that United’s decision was not arbitrary and capricious and remanded the case for further consideration. A.C. was covered ..read more

In Radle v. Unum Life Insurance Company of America, No. 4:21CV1039 HEA, 2023 WL 8449084 (E.D. Mo. Dec. 6, 2023), Missouri Eastern District Judge Henry Edward Autrey denied Plaintiff’s motion to dismiss Unum’s counterclaim for recovery of overpayment due to Plaintiff’s award of Social Security Disability Insurance (SSDI) benefits, finding that Unum had adequately pled a claim for relief under ERISA and the applicable long-term disability (LTD) Plan. Most LTD plans include offsets for SSDI benefits a claimant receives. Many LTD plans insured by Unum contain the following language: Unum will subt ..read more