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UNUM LIFE INS. CO. OF AMERICA v. WARD, ___ U.S. __ (April 20, 1999)-
1. California's notice-prejudice rule is a "law ... which
regulates insurance," and is therefore saved from preemption by ERISA. Pp. 5-14.2. The Court rejects UNUM's assertion that the
notice-prejudice rule conflicts in three ways with substantive provisions of ERISA.3. California's Elfstrom agency rule "relate[s] to"
ERISA plans, and therefore does not occupy ground outside ERISA's preemption clause.
Devlin v. Transportation Communications
International Union, 1999 U.S. App. LEXIS 6969 (2nd Cir. Apr 13, 1999)-This is a claim of retirees regarding the amendment of their retiree medical plan. Before the amendment the retirees did not have to pay for their health coverage. After the amendment the retirees had to pay $ 100 per month premium. Second Circuit affirmed district court's decision that Plaintiffs did not have a claim for promissory estoppel under ERISA since the case did not meet the four requirements to be extraordinary circumstances. Second Circuit also held that the district court correctly determined that the plan sponsor correctly followed the procedure to amend the plan.Devlin v. Transportation Communications
International Union, 1999 U.S. App. LEXIS 7531 (2nd Cir. Apr 13, 1999)-Case involved the elimination of a death benefit fund and the elimination of a cost-of-living allowance for the retirement plan. Second circuit held that the elimination of the death benefit did not involve ERISA since the $300 death benefit (unchanged since 1930) was not an ERISA plan. The Court also determined that the Plaintiffs lacked standing to challenge the elimination of the COLA since a district court in Maryland was addressing the issue.LABORERS LOCAL 17 HEALTH AND BENEFIT FUND v. PHILIP MORRIS,
INC., 1999 U.S. App. LEXIS 6336 (2nd Cir. Apr 9, 1999)-Second Circuit reverses district court's refusal to dismiss complaint and orders dismissal. Plans sued tobacco companies alleging that tobacco companies misled the public regarding the harmfulness of smoking. The public smoke and thus caused the plans harm from the costs of providing health care for smoking related illnesses. Second Circuit dismissed since plan's injuries are too remote to allow them to recover.SHEPLEY v. NEW COLEMAN HOLDINGS INC.,
1999 U.S. App. LEXIS 6066 (2nd Cir. Apr 1, 1999)-Court determined that the reversion of plan assets to employer following the termination of a defined benefit plan did not violate 29 U.S.C. § 1344(d)(1)(C).
GEORGETOWN UNIVERSITY HOSPITAL v. RELIANCE
STANDARD LIFE INSURANCE COMPANY, 1999 U.S. App. LEXIS 7803 (4th Apr 22, 1999) (unpublished)-Court affirmed the decision of the district court to deny the Plaintiffs' claim for unpaid medical benefits. The Plan was self-funded with a stop-loss carrier. Sponsor of self-funded plan became insolvent. Court held that self-funded plans may not look to assets of stop-loss carrier.
LABORERS NATIONAL PENSION FUND v. NORTHERN TRUST QUANTITATIVE ADVISORS, INC., 1999 U.S. App. LEXIS 7272 (5th Cir. Apr 16, 1999)-Court in reversing and rendering the district court's decision that the defendants' acted imprudently when purchasing Interest-Only Mortgage securities, restated that the focus of the Court's inquiry is how the fiduciary made its decision, not the results of the decision.
GILES v. NYLCARE HEALTH PLANS, INC., 1999 U.S. App. LEXIS 6370 (5th Cir. Apr 9, 1999)-Fifth Circuit affirmed the remand of a claim for vicarious liability and negligence claims against an HMO for medical malpractice. Fifth Circuit held that a district court does not have jurisdiction under "conflict preemption". Court specifically held that district court has the discretion to remand a case involving solely arguably conflict-preempted causes of action. Court specifically overruled Burks v. Amerada Hess Corp., 8 F.3d 301, 304 (5th Cir. 1993).
ARBOR HEALTH CARE CO. v. SUTPHEN
CORP., 1999 U.S. App. LEXIS 8565 (6th Cir. April 30, 1999) (Unpublished)-ERISA preempts claims under state law claims for estoppel, fraud and breach of contract. The plan was an ERISA plan since the employer paid 80% of the premiums. See detailed analysis.LAMBERT v. AETNA LIFE INSURANCE
COMPANY, 1999 U.S. App. LEXIS 7368 (6th Cir. Apr 12, 1999)(unpublished)-Sixth Circuit affirmed grant of summary judgment of claim under ERISA 510 since Plaintiff quit and offered no evidence that Aetna had the specific intent of interfering with her benefits.KROHN v. HURON MEMORIAL HOSPITAL, 1999 U.S. App. LEXIS 5798; 1999 FED App. 0122P (6th Cir.) (6th Cir. Apr 1, 1999)-Defendant breached its fiduciary duty and thus liable for payment of disability benefits when it failed to submit claim timely to UNUM. UNUM denied the claim as untimely. Defendant also breached its fiduciary duty when it failed to provide accurate information regarding disability benefits to spouse of injured participant.
Commonwealth Edison Company v. Vega, 1999 U.S. App. LEXIS 7215
(Apr 13, 1999)-ERISA preempts state unclaimed property laws.
Ince v. Aetna Health Management, Inc., 1999 U.S. App. LEXIS 6352 (8th Cir. Apr 9, 1999)-plaintiffs receiving health care benefits were injured and received benefits from third parties settled subrogation claims and brought action alleging violations of ERISA and state law claims; dismissal of claims affirmed -- no breach of fiduciary duty and no breach of plan. See detailed analysis.
DuMond v. Centex Corp., 1999 U.S. App. LEXIS 6651 (8th Cir. Apr 9, 1999)-ERISA; denial of long-term disability benefits affirmed; medical records did not support Chronic Fatigue; Syndrome; no denial of full and fair review of claim. See detailed analysis.
KEARNEY v. STANDARD INSURANCE COMPANY, 175 F.3d 1084 (en banc)-The language "upon receipt of satisfactory written proof that you have become DISABLED[.]" does not grant discretion. See detailed analysis.
LEWIS v. FESTO CORPORATION, 1999 U.S. App. LEXIS 8324 (9th Cir. Apr 28, 1999) (unpublished)-Court affirmed District Court's grant of summary judgment on claim under ERISA § 510.
