Practice Tips

:: Should ERISA Attorneys Be Held Liable For Aiding & Abetting A Fiduciary Breach?

May an attorney be held liable for aiding and abetting a fiduciary breach? A recent law review article raises the issue and advocates the view. The article isn’t written for an ERISA audience, but it suggests the idea – should attorneys be held liable for advising ERISA fiduciaries on actions that are found to constitute …

:: Should ERISA Attorneys Be Held Liable For Aiding & Abetting A Fiduciary Breach? Read More »

:: Disclaimer Shields Claims Administrator From Mispresentation Claims

Tenet alleges that it provided approximately $ 241,000 worth of medical services to Sylvester based on UniCare’s representation that Sylvester was covered under the Plan. . . .  Pursuant to the Managed Care Agreement, UniCare paid Tenet $ 132,827.34, the negotiated payment under the agreement, on July 27, 2005.  On August 5, 2005, Sheltering Arms …

:: Disclaimer Shields Claims Administrator From Mispresentation Claims Read More »

:: Sixth Circuit Opinions Applying Estoppel In ERISA Cases – An Anthology

Estoppel under ERISA is an equitable doctrine of the federal common law of contracts designed to enforce ERISA and the agreements made under it. Armistead v. Vernitron, 944 F.3d 1287, 1298 (6th Cir. 1991). There are five elements to an estoppel claim under ERISA: (1) a representation of fact made with gross negligence or fraudulent …

:: Sixth Circuit Opinions Applying Estoppel In ERISA Cases – An Anthology Read More »

:: Strategic Decisions In Pleading (And Defending) Provider Reimbursement Claims – A Case Study

St. Luke’s may amend within thirty days. If St. Luke’s amends to assert an ERISA claim, the personal jurisdiction issue is far simpler.  “[U]nder ERISA’s nationwide service of process provision,” 29 U.S.C. § 1132(e)(2), “[a] court may exercise personal jurisdiction over the defendant if it determines that the defendant has sufficient ties to the United …

:: Strategic Decisions In Pleading (And Defending) Provider Reimbursement Claims – A Case Study Read More »

:: 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 …

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

:: Indemnification Provisions: Do They Apply To Excuse A Party’s Own Wrongdoing?

Only after the first tranche of the settlement funds had been distributed was a challenge raised in late January 2007 by a dissatisfied class member as to the accuracy of the distribution. Upon investigating, Hewitt represents that it discovered that an archived computer system used to calculate ESOP class member allocations contained an incorrect share …

:: Indemnification Provisions: Do They Apply To Excuse A Party’s Own Wrongdoing? Read More »