275 results for 'nos:"Employee Retirement Income Security Act (ERISA) - Labor"'.
J. Carter overturns the insurance company's decision to terminate the industrial engineer's long-term disability benefits and life waiver of premium in February 2020 after the industrial engineer suffered a cardiac arrest in August 2016, which caused his multiple cardiovascular medical conditions and cognitive deficits that made it impossible for him to perform the material duties of his job. The insurance company's own hired expert corroborated testimony that the industrial engineer's cognitive impairment qualifies him as disabled, and the treadmill tests that the insurance company had him perform do not prove that the industrial engineer can tolerate occupational stress.
Court: USDC Central District of California, Judge: Carter, Filed On: November 7, 2023, Case #: 8:22cv181, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Experts
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J. Mueller grants a benefit plan’s motion to dismiss a hospital’s action accusing it of refusing to pay for a patient’s $500,000 chemotherapy treatment. The hospital's claims, as pleaded, are not plausible under the Affordable Care Act.
Court: USDC Eastern District of California, Judge: Mueller, Filed On: November 1, 2023, Case #: 2:23cv676, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Health Care, Insurance
J. Mollway declines a sheet metal contractor’s motion to dismiss this ERISA class action on the argument that the use of the word “may” only permits, and does not require, arbitration. “While the arbitration language could have been clearer, its use of ‘may’ is not grounds for dismissal.” The court directs both parties to meet and confer before Nov. 8, 2023.
Court: USDC Hawaii, Judge: Mollway, Filed On: October 26, 2023, Case #: 1:23cv280, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Arbitration, Erisa, Class Action
J. Durkin grants a broiler chicken distributor’s motion to dismiss antitrust claims against it for allegedly conspiring to fix chicken prices higher than the market would otherwise support. The class of purchasers has not established antitrust standing for the purposes of their Sherman Act claims, nor for relevant state antitrust claims. The broiler chicken distributors are entitled judgment related to damages prior to Sept. 2, 2012, which is when they learned of the alleged conspiracy, and to violations of the Sherman Act and antitrust violations.
Court: USDC Northern District of Illinois, Judge: Durkin, Filed On: October 23, 2023, Case #: 1:16cv8637, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Agriculture, Antitrust
J. Zilly grants the bioinformatics engineer's motion for judgment on the record in this case concerning the denial of benefits under a long-term disability insurance policy. The individual was diagnosed with numerous medical diagnoses, and the insurance provider denied her claim when it determined the policy was not effective during the incurred date. The company is ordered to pay the long-term disability claim with the offset of her social security disability benefits or any other income from this order date until to the end of maximum benefits.
Court: USDC Western District of Washington, Judge: Zilly, Filed On: October 6, 2023, Case #: 2:21cv1424, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Insurance
J. Zilly grants the participants and beneficiaries’ motion to certify class, which will include any member who invested funds in the Profit Sharing and Retirement Plan. The class representative, class counsel and local counsel are appointed by the court, ordering the parties 21 days to submit a joint status report.
Court: USDC Western District of Washington, Judge: Zilly, Filed On: October 6, 2023, Case #: 2:22cv37, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Insurance, Class Action
J. Norris grants in part the funds' motion for entry of default judgment in this lawsuit brought under the Employee Retirement Income Security Act regarding unpaid contributions. The company defendants failed to timely respond to the complaint, and the clerk properly entered a default. The court now concludes that the defendant company has breached a repayment agreement, as well as the collective bargaining agreement. The individual defendant is dismissed, however, as to the breach of contract claim against him.
Court: USDC Western District of Tennessee , Judge: Norris, Filed On: October 6, 2023, Case #: 2:23cv2071, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Contract, Labor
J. Auld denies a former Duke University Medical Center doctor’s second motion to compel discovery pursuant to ERISA to recoup long-term disability benefits under his insurance plan. The doctor requests discovery of information he believes the company has withheld. However, the company has repeatedly provided all information requested and, so, will not be tasked with providing more.
Court: USDC Middle District of North Carolina, Judge: Auld, Filed On: October 4, 2023, Case #: 1:22cv605, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Insurance, Contract
J. Azrack compels to arbitration a putative class action ERISA suit bought by a former regional manager that alleges her employer, Luxottica, an Italian eyewear designer, miscalculated her monthly pension payments due to their reliance on mortality assumptions that she claims is 50 years out of date. The court finds the arbitration clause is enforceable and expressly covers claims arising under ERISA.
Court: USDC Eastern District of New York, Judge: Azrack, Filed On: September 30, 2023, Case #: 2:21cv6072, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Class Action
J. Crocker partially grants the beneficiary's motion for attorney fees in his lawsuit against the insurance company over the termination of his long-term disability benefits. The beneficiary is entitled to some fees in part because his allegation that the company failed to perform a full and fair review of his disability claim ultimately prevailed upon appeal to the Seventh Circuit, but his success on a "distinct procedural issue" calls for a reduction of the lodestar, and the beneficiary is awarded $41,944 in attorney fees and $907 in costs.
Court: USDC Western District of Wisconsin, Judge: Crocker, Filed On: September 29, 2023, Case #: 3:21cv19, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Insurance, Attorney Fees
J. Grimberg finds in favor of the insurance company in a lawsuit from a beneficiary over the denial of her claim for long-term disability benefits filed when she stopped working after being diagnosed with scleroderma. The company successfully argues that given the timing of when the beneficiary became insured under the policy, when she received treatment for worsening symptoms and when she was actually diagnosed, her scleroderma was technically a pre-existing condition because she was treated for it during the three-month "look-back period" prior to her policy becoming effective, even though she was not diagnosed until after this period ended. These facts make the company's denial reasonable and neither arbitrary nor capricious, and the company's motion for summary judgment is granted and the beneficiary's motion for judgment on the administrative record is denied.
Court: USDC Northern District of Georgia, Judge: Grimberg, Filed On: September 29, 2023, Case #: 1:21cv2900, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Insurance, Contract
J. Mauskopf awards a pension fund $309,013 on its ERISA claims that sought to collect on a construction company’s unpaid withdrawal liabilities, finding the fund was in compliance with their collective bargaining agreement’s notification requirements.
Court: USDC Eastern District of New York, Judge: Mauskopf, Filed On: September 29, 2023, Case #: 2:19cv1214, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Pensions, Labor / Unions
J. Osteen dismisses the remaining claims, for lack of subject matter jurisdiction, brought by a former employee who says he was cheated out of his pension after his employer merged with another, larger firm. The entities the retiree sues are not proper parties to his ERISA claims.
Court: USDC Middle District of North Carolina, Judge: Osteen, Filed On: September 28, 2023, Case #: 1:21cv274, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Civil Procedure, Pensions, Jurisdiction
J. Aiken grants judgment in favor of the daughter for her complaint alleging that Legacy Health wrongfully denied her claim for mental health treatment even though her mother is a participant of the employee welfare benefits plan. The lack of pre-approval is not a stated basis to deny the daughter coverage because although there were available in-network options, her mother was told that retroactive authorization was an option and PacificSource denied the request despite not seeking authorization until after the daughter already received treatment.
Court: USDC Oregon, Judge: Aiken, Filed On: September 28, 2023, Case #: 6:20cv705, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, Health Care, Insurance