LITIGATION

:: ERISA Plan Claims Dismissed As Jurisdictionally Flawed

Plaintiff also claims it is a fiduciary. However, Plaintiff has offered no authority for this claim, nor does the amended complaint contain allegations that would support this contention. Plaintiff merely alleges that it is an employee welfare benefit plan established and maintained to provide insurance and related benefits to participants and beneficiaries. (Plaintiff’s Amended Complaint, …

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:: How To Address Protected Health Information Issues Under HIPAA In ERISA Litigation

Whether plaintiff or defendant, obligations to protect health information increasingly present obstacles to progress in ERISA litigation. A recent district court order serves as an example of how parties may reach an accord that assures confidentiality of protected health information without thwarting necessary discovery in development of issues central to the case.

:: District Court Holds That Procedural Conflict Results In Expanded Discovery Rights

Two types of potential conflicts can be alleged by a plaintiff, a structural conflict or a procedural conflict. “The structural inquiry focuses on the financial incentives created by the way the plan is organized, whereas the procedural inquiry focuses on how the administrator treated the particular claimant.” Post, 501 F.3d at 162. A structural conflict …

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:: Fifth Circuit Holds That ERISA Fiduciary Insurance Coverage Does Not Encompass Alleged COBRA Violations

he relevant Policy provisions, which are expressly described as providing “fiduciary liability coverage,” only insure against claims of “wrongful acts.” The Policy defines “wrongful acts” as  “any breach of the responsibilities, obligations or duties imposed upon fiduciaries of the Sponsored Plan by [ERISA], as amended, . . . or any negligent act, error or omission …

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:: District Court Holds That Potential Claim For Benefits Forecloses Other ERISA Relief

On September 13, 2006, Mr. Tebbetts consulted with a doctor because he was experiencing pain in his abdomen, and the doctor ordered a CT scan of Mr. Tebbetts’ abdomen. The doctor sought pre-approval from Defendants of the CT scan, but Defendants declined coverage. Several days later, Mr. Tebbetts was taken to the hospital where a …

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:: Discovery Of Claims Administrator’s Personnel Records Permitted On Question Of Bias

Based on Glenn and Abatie, therefore, it is within the discretion of the district court to permit limited discovery in an ERISA case. Any discovery, however, “must be narrowly tailored and cannot be a fishing expedition.” Groom v. Standard Ins. Co, 492 F. Supp. 2d 1202, 1205 (C.D. Cal. 2007). Sullivan v. Deutsche Bank Ams. …

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:: Plan Administrators Cannot Invoke “SPD Prevails” Rule To Cure Plan Language Deficiencies

Here, there are no terms in the plan which allow it to be amended by inserting into the SPD such critical provisions as the administrator’s discretionary authority to interpret the plan or to determine eligibility for benefits. Indeed, this particular plan wholly fails to comply with § 1102(b)(3)’s requirement to include a procedure governing amendment …

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