302 results for 'cat:"ERISA"'.
J. Christen finds that the district court improperly dismissed an action brought by pension plan participants, alleging that the plan administrator violated ERISA by not providing pension benefit statements automatically or on request. The participants adequately pleaded an ERISA violation based on their allegation that they made written requests which were "sufficient to trigger the duty to produce pension benefit statements." Reversed.
Court: 9th Circuit, Judge: Christen, Filed On: May 9, 2024, Case #: 22-55634, Categories: Employment, erisa
J. Scudder finds that the lower court properly found for the plan administrator in an ERISA suit challenging its denial of an employee's disability claim based on his worsening fatigue due to his multiple sclerosis. Multiple medical reports found that the employee could work 8-hour days and could continue working in his field, even if his current employer denied his request to reduce his shifts from 12 to 8 hours. The administrator presented rational reasons for its decision based on a fair reading of the plan and the employee's medical records. Affirmed.
Court: 7th Circuit, Judge: Scudder, Filed On: May 6, 2024, Case #: 23-2269, Categories: erisa
J. Nye denies in part an employer's and insurer's motion to dismiss a father and employee's allegations of violation of The Mental Health Parity and Addiction Equality Act (MHPAEA) after his son, a beneficiary of the plan, was denied benefits for inpatient and outpatient mental health treatment following the son's suicide attempt. The father "has presented a plausible cause of action that Defendants violated the MHPAEA by requiring more of persons seeking mental health/substance abuse treatment than other medical treatments."
Court: USDC Idaho, Judge: Nye, Filed On: May 2, 2024, Case #: 1:23cv221, NOS: Insurance - Contract, Categories: erisa, Insurance
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J. Robinson finds that the district court properly declined to compel arbitration in fiduciary duty claims an employee brought against the company and the trustee of the contribution retirement plan. The arbitration provision was unenforceable under ERISA because the provision limited relief available to an individual's account and barred a plan-wide remedy. Affirmed.
Court: 2nd Circuit, Judge: Robinson, Filed On: May 1, 2024, Case #: 21-2891-cv, Categories: erisa, Fiduciary Duty
J. Mehalchick denies a nursing home’s motion for summary judgment concerning a former employee’s Fair Labor Standards Act claim alleging a failure to pay overtime compensation. There is a question of material fact as to whether the former employee’s primary duty was managerial and thus exempt from overtime compensation. The former employee’s motion for partial summary judgement for liquidated damages was also denied since the decision would be merely advisory.
Court: USDC Middle District of Pennsylvania, Judge: Mehalchick, Filed On: May 1, 2024, Case #: 3:22cv828, NOS: Fair Labor Standards Act - Labor, Categories: Civil Rights, Employment, erisa
J. Groves grants an insurance company's and employer's motions to dismiss a disabled inactive employee's amended complaint regarding denied claims. The United States Department of Labor Employee Benefits Security Administration issued demand letters on behalf of the employee identifying multiple incorrectly processed claims. The insurer overturned some, but not all, decisions. The employee requested plan documents from the insurer, received no response, and filed this complaint alleging violation of ERISA for not producing the requested documents. Because the employee has not alleged an injury, she does not have Article III standing. The insurer is not a proper party for the ERISA claim. The employee did not make a written request to the employer for plan documents.
Court: USDC Idaho, Judge: Groves, Filed On: April 29, 2024, Case #: 1:22cv164, NOS: Fair Labor Standards Act - Labor, Categories: erisa
J. Buth finds that the lower court improperly dismissed all the employees' ERISA claims against the company. To the extent the employees seek recovery for conduct taking place after November 2012, the claims are timely. Reversed in part.
Court: 7th Circuit, Judge: Wood, Filed On: April 23, 2024, Case #: 23-1073, Categories: Civil Procedure, erisa
J. Oliver grants, in part, the insurer's motion to dismiss, ruling the union's fiduciary duty claims fail. The alleged increased rates charged by the insurer were determined by the parties' contractual agreements and involved no discretion on the part of the insurer.
Court: USDC Connecticut, Judge: Oliver, Filed On: April 22, 2024, Case #: 3:22cv1541, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, Fiduciary Duty, Labor / Unions
J. Menendez grants the fringe benefit plan trustees' motion for default judgment and an injunction against the employer in their case alleging failures to make fringe benefit contributions and reports required under collective bargaining agreements. The facts alleged in the trustees' complaint, accepted as true, provide a basis for a breach of contract action, and given the employer's nonresponse to the complaint, it is liable for delinquent contributions, interest and liquidated damages. It is also ordered to submit contribution reports or payroll books and records.
Court: USDC Minnesota, Judge: Menendez, Filed On: April 16, 2024, Case #: 0:23cv1273, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, Labor
J. Snyder denies in part an investment consulting group's motion to dismiss a pension fund's allegations of breach of fiduciary duty under ERISA. The pension fund alleges that the investment consulting group recommended a program management company and concealed information regarding the company's lack of experience and its owner's financial difficulties. The pension fund later found that some portfolio companies the management company had invested in were "worthless" and claims the consulting group failed to properly investigate the program management company. The pension fund has ERISA standing and has sufficiently pleaded its breach of fiduciary duty claim under ERISA. The fund is granted leave to amend its remaining claims.
Court: USDC Central District of California, Judge: Snyder, Filed On: April 15, 2024, Case #: 2:23cv7726, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, Fiduciary Duty
Per curiam, the circuit finds that the district court properly confirmed an arbitration award assessing withdrawal liability against a business that contributed to a multi-employer union pension fund. The ERISA exemption from liability did not apply when the business shut down because the firm and its predecessor-in-interest provided installation and maintenance for Time Warner Cable in the New York City area, services which were not part of the building and construction industry. Affirmed.
Court: 2nd Circuit, Judge: Per curiam, Filed On: April 15, 2024, Case #: 23-647-cv, Categories: erisa
J. Clifton reverses in part and affirms in part a district court judgment in a putative class action under ERISA. The class alleged that UnitedHealthcare applied a "more stringent review process" to benefits claims for outpatient, out-of-network mental health and substance use disorder treatment than to otherwise comparable medical and surgical treatments. The class adequately stated a claim for a violation of the Parity Act and dismissal on that claim and the breach of fiduciary duty claim are reversed. However, the lower court correctly dismissed claims based on a violation of the terms of the employment plan. Affirmed in part.
Court: 9th Circuit, Judge: Clifton, Filed On: April 11, 2024, Case #: 22-55761, Categories: Employment, erisa, Health Care
J. Ross finds a Long Island surgical practice’s claims against a union benefits fund for breach of contract and unjust enrichment, alleging failure to provide reimbursement for medical services, are preempted by ERISA and declines to remand the case back to state court.
Court: USDC Eastern District of New York, Judge: Ross, Filed On: April 10, 2024, Case #: 2:23cv6145, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, Contract, Labor / Unions
J. Alston grants the physical therapist motion for summary judgment in this ERISA action. The physical therapist stopped working due to symptoms of arthralgia, back pain, neck pain from cervical herniated discs, fibromyalgia, chronic fatigue, Epstein Barre virus, IBS, and migraines. After several years of long-term disability, primarily for cognitive issues, the insurance company denied her 2022 request on the grounds that she had published books and began a blog during her time away from work. The therapist's doctor continued to vouch for her, saying she would be unable to do her job. The insurer wrongfully ignored that evidence and relied solely on outlier opinions to determine its denial.
Court: USDC Eastern District of Virginia, Judge: Alston, Filed On: April 10, 2024, Case #: 1:23cv1, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, Insurance, Labor
J. Aenlle-Rocha grants an insured's motion to overturn the insurer's denial of benefits for his son's treatment at a residential care facility. The treatment was denied as "not medically necessary" despite the insured's appeal with neuropsychological assessments, five letters of medical necessity from treatment providers, and thousands of pages of medical records and treatment notes. The insured "has satisfied his burden of proving medical necessity as to the treatment at issue with credible, persuasive evidence." The insurer denied the claim without sufficient explanation and "disregarded relevant medical evidence and did not afford [the insured] a full and fair review of his claims."
Court: USDC Central District of California, Judge: Aenlle-Rocha, Filed On: April 9, 2024, Case #: 2:23cv6413, NOS: Other Contract - Contract, Categories: erisa, Insurance, Contract
J. Whitney grants a global agricultural products firm’s motion for judgment on the pleadings following allegations of ERISA protections violations brought by an employee after a dispute over benefits involving his ex-wife. The employee argues he was wrongfully denied benefits because some of his ERISA payouts went to furnish his ex-wife as a beneficiary after their divorce. However, an ERISA plan administrator previously denied the employee’s claim for breach of fiduciary duty and his appeal. Here, he alleges wrongful denial of benefits, but the claim is redundant
Court: USDC Western District of North Carolina, Judge: Whitney, Filed On: April 3, 2024, Case #: 3:23cv512, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: erisa, Fiduciary Duty