The Fifth Circuit concluded that a plan participant was not entitled to recover attorneys’ fees for obtaining a remand order requiring the district court to apply a de novo, rather than abuse of discretion, standard of review to the administrative determination of her benefit claim. In so ruling, the Court applied the principles enunciated
benefit claim
Plan Participant Waived Remedy for Untimely Benefits Determination
By Benjamin Flaxenburg on
The Seventh Circuit rejected a disability plan participant’s argument that an untimely decision denying his claim for long-term disability benefits warranted changing the standard of review from arbitrary and capricious to de novo. In so ruling, the Court explained that had plaintiff filed suit once the time for a timely decision had passed (because his…
Ninth Circuit Considers Pre-Appeal Conduct in Plan’s Request for Appellate Attorney’s Fees
By Benjamin Flaxenburg on
The Ninth Circuit ruled that a district court erred by failing to consider the entire course of the litigation when analyzing a request for attorney’s fees under ERISA and remanded the case for a calculation of fees. A plan participant filed suit against a plan and insurer seeking disability benefits. The plan, in turn, filed…
ERISA Participant’s Supplemental Submission Doesn’t Restart Exhaustion Clock
By Madeline Chimento Rea on
A federal district court in New Jersey held that supplemental documentation submitted by a participant in connection with the claims review process did not restart the clock for a claims administrator to decide the participant’s appeal. Plaintiff Tracee Lewis-Burroughs timely appealed Prudential Insurance Company of America’s decision to stop paying her long-term disability benefits.