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Lions Volunteer Blind Industries, Inc. v. Automated Group Administration, Inc., 1999 U.S. App. LEXIS 28397 (6th Cir. November 2, 1999); 1999 FED App. 0376P (6th Cir.)-ERISA preempts state law claim of misrepresentation involving switching of an insured medical plan with a self-insured plan. Go to detailed analysis.
Feldman v. American Memorial Life Insur. Co., 1999 U.S. App. LEXIS 29360 (7th Cir. November 9, 1999)-No standing to bring 510 claim if not eligible for the claimed benefits in the first place. Go to detailed analysis.
Perlman v. Swiss Bank Corporation Comprehensive Disability Protection Plan, 1999 U.S. App. LEXIS 28143 (7th Cir. November 2, 1999)-Seventh Circuit questioned whether a district court can order a remand to the plan administrator. Seventh Circuit determined that an order remanding a case to the plan administrator is appealable. Circuit court found no conflict of interest since UNUM is a large corporation. Go to detailed analysis.
Emmenegger v. Bull Moose Tube Co., 1999 U.S. App. LEXIS 30579 (8th Cir. November 24, 1999)-Phantom stock plan was not an ERISA plan; severance plan was an employee welfare benefit plan under ERISA; case remanded for further proceedings. Go to detailed analysis.
McDaniel
v. Medical Life Insur. Co.,
1999 U.S. App. LEXIS 28423 (8th Cir. November 3, 1999)
Melvin v. Yale Industrial Products, Inc., 197 F.3d 944 (8th Cir. 1999)-Pilot was engaged in an occupational activity at the time of his crash and injuries sustained in the accident were not covered under the defendant's health care plan. Go to detailed analysis.
Goodberry v. Northrop Grumman Long Term Disability Income Plan, 1999 U.S. App. LEXIS 29507 (9th Cir. November 4, 1999) (unpublished)-Court held for de novo review because plan administrator failed to distribute SPD containing discretionary language. Claims administrator's failure to get vocational opinion is not an abuse of discretion since doctors indicated that Goodberry could work at a sedentary job. Go to detailed analysis.
Aberle v. Integrity Life Insur. Co., 1999 U.S. App. LEXIS 29473 (9th Cir. November 4, 1999) (unpublished)-This court found that the district court correctly applied a de novo standard of review since the benefit plan did not “give the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan.” The district court properly concluded that the reasons given by UNUM in its denial letters were sufficient, where UNUM raised issues regarding Aberle's credibility, inconsistencies between his observed activities and a diagnosis of disabling chronic fatigue syndrome, the subjective nature of the medical evidence, and medical opinions that Aberle was not disabled under the terms of the policy. Go to detailed analysis
Tremain v. Bell Industries, Inc., 196
F.3d 970 (9th Cir. 1999)
Since the plan failed to carry the burden of rebutting the presumption, this court directed the district court to review de novo MetLife’s decision to deny benefits. It further required a trial instead of summary judgment, because there were genuine issues of material fact as to Tremain’s “total disability” and as to the amount of Tremain's benefits. Go to detailed analysis
Sawyer v. Pacificare of California, 1999 U.S. App. LEXIS 30136 (9th Cir. November 17, 1999) (unpublished)-This court affirmed the district court’s dismissal of Sawyers’ breach of contract and covenant of good faith and fair dealing claims against Sawyers’ HMO provider, PacifiCare, because ERISA preempted the Sawyers' state claims. Go to detailed analysis.
CSA 401(k) Plan v. Pension Professionals Inc., 195 F.3d 1135 (9th Cir. 1999)-After employees of CSA discovered embezzlement from their employee benefit plan, they filed suit against Pension Professionals, Inc. (PPI). This court found that PPI was not an ERISA fiduciary because there was no showing that PPI exercised actual control or discretionary authority over the Plan itself. Go to detailed analysis.
Kimber v. Thiokol Corp., 1999 U.S. App. LEXIS 29533 (10th Cir. November 10, 1999)-Contra proferentem not available if plan administrator has discretion to interpret plan terms and the review is abuse of discretion. Go to detailed analysis.
Lang v. Aetna Life Insur. Co., 196 F.3d 1102 (10th Cir. 1999)-This court affirmed the district court’s dismissal of Lang’s suit for recovery of long-term disability benefits as time-barred. Go to detailed analysis.
Rock v. Unum Life Insur. Co., 1999 U.S. App. LEXIS 29859 (10th Cir. Nov. 15, 1999) (unpublished)-This court affirmed the district court's judgment in favor of defendant UNUM on Rock’s claims for disability benefits. Go to detailed analysis.
Moore v. Berg Enterprises, Inc., 1999 U.S. App. LEXIS 30481 (10th Cir. Nov. 23, 1999) (unpublished)-This court affirmed the district court’s holding that Moore’s claims were time barred. In this case, the plan itself contained a limitations period. Under the Plan, once Moore had been totally disabled for 180 days, he had ninety- (90) days to submit a proof of claim. Once that 90-day period ended, Moore had three (3) years to file suit. Go to detailed analysis.
Mills
v. Unum Life Insur. Co.,
1999 U.S. App. LEXIS 30484 (10th Cir. Nov. 23, 1999) (unpublished)-Plaintiff
Patsy Mills, the surviving spouse of Ramon H. Mills, brought this action under
ERISA, seeking disability benefits under the long term disability (LTD) plan
supplied by Mr. Mills’ employer. This court affirmed the district court’s
summary judgment in favor of defendants.
Furthermore, this court found that plaintiff counsel's failure to dismiss UNUM as a defendant after March 3, 1998, (when a deposition made it clear that UNUM had not denied a valid claim ) was objectively unreasonable conduct that justified the district court's imposition of attorney's fees. Go to detailed analysis.
