The Sixth Circuit recently concluded that a disability plan participant was entitled to relief consisting of benefits under the plan and disgorgement of defendant’s profits for delaying payment. In so ruling, the Court found that this case presented a “a logical extension” of its precedent allowing a plaintiff to pursue in limited circumstances both a
Remedies
Express Plan Terms Allow Self-Insured Plan to Recover Medical Benefits Paid to Employee Post-McCutchen
By Anthony Cacace on
In Quest Diagnostics v. Bomani, et al., 11-CV-00951 (D. Conn., June 19, 2013), the court granted Quest Diagnostic’s (“Quest”) motion for summary judgment, ruling that Quest, as the fiduciary to its self-insured medical plan, could recover medical benefits paid to its employee after the employee was injured in an accident and recovered a…
U.S. Supreme Court Rules That Plan Terms Trump Equitable Defenses
By Myron Rumeld & Russell Hirschhorn on
Today, the U.S. Supreme Court issued its ruling in U.S. Airways, Inc. v. McCutchen in which the Court unanimously ruled that a clearly drafted reimbursement clause will trump all equitable defenses. The Supreme Court’s ruling will likely be viewed favorably by plan sponsors, as it will allow them to anticipate with more certainty the impact…
Monetary Damages Potentially Available For Inadequate Disclosure
By Brian Neulander on
In Weaver Bros. Ins. Assoc., Inc. v. Braunstein, No. 11-5407, 2013 WL 1195529 (E.D. Pa. Mar. 25, 2013), a district court denied the plan administrator’s motion for judgment on the pleadings, ruling that monetary relief may be available for ERISA violations associated with the plan administrator’s failure to properly communicate the participant’s benefit rights…