Dewitt and her husband, Anthony, were covered under Proctor’s health insurance plan. Throughout Dewitt’s tenure at Proctor, Anthony suffered from prostate cancer and received expensive medical care. His covered medical expenses were paid by Proctor, …
While the Court is not unsympathetic to Defendants, it recognizes that the Fund has a fiduciary responsibility to enforce its lien on the proceeds of Defendants’ workers’ compensation settlements in order maintain the solvency of …
Plaintiff relies on a provision titled, “Third-Party Liability (Subrogation)” but Premera is not asserting subrogation rights. Premera might have asserted subrogation rights if Allied had not paid the PIP benefit, but Allied did so. Nor …
Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989), establishes the principle that courts review de novo an ERISA benefits determination unless the plan confers discretionary authority on its administrator. In this case …
No case has been brought to the attention of this Court holding that a health care provider loses its ability to sue for damages in state court when they also request medical bill payment under …
The question before the court is whether the arbitration panel manifestly disregarded the law when it awarded Plaintiff almost $ 4 million in damages. Since the Panel provided no written findings on which it based …
Finally, we should note that while the LaRue Court only decided statutory standing in its opinion, it did not ignore constitutional standing, nor could it have ruled on statutory standing had the requirements of constitutional …
SCOTUSBLOG has announced that the Supreme Court has released the opinion in MetLife v. Glenn(06-923). The key issue before the Court in that case was whether the fact that a claim administrator of an ERISA …
If a health insurer issues coverage to an employer group, stipulating that coverage is available to employees regularly working 30 hours per week, who may decide whether an employee meets the eligibility requirement – the …
Although Standard’s plan does not use the word “discretion,” it uses a variety of equivalent terms that convey the same meaning. See supra (”full and exclusive authority to control and manage, . . . to …