52 results for 'cat:"Employment" AND cat:"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. Kelly grants the coal company owner's estate's and the company's subsidiaries' motion to dismiss the miners' pension plan's trustees' suit alleging that the coal company's withdrawal from a collective bargaining agreement during its 2019 bankruptcy proceedings left the subsidiaries with $6.5 billion in withdrawal liability. Under the agreement, for trustees to take action on behalf of the plan, that action requires agreement by one of two union trustees and one of two employer trustees. In this case, the employer trustee pursuing the action was not properly appointed as a trustee, having been appointed as an alternate only for the purpose of addressing matters related to the bankruptcy. That trustee was not a "successor" trustee or otherwise sufficiently authorized to bring this suit.
Court: USDC District of Columbia, Judge: Kelly, Filed On: March 30, 2024, Case #: 1:21cv567, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Trusts
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J. Bumb remands to state court a complaint alleging that the law firm and real estate holding company wrongfully failed to provide the attorney with retirement benefits after firing her. The retirement plan fell outside ERISA because there is no information on the procedures for obtaining the post-retirement income, nor information on how to challenge the decision to deny benefits. Further, there is no evidence the attorney fraudulently joined the partner or the law firm in the underlying whistleblower claim to avoid remand.
Court: USDC New Jersey, Judge: Bumb, Filed On: March 20, 2024, Case #: 1:23cv4224, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Jurisdiction
J. Trauger grants the defendant plan administrators' motion for judgment on the administrative record in this dispute over early retirement benefits. The administrators' decision to deny benefits based on the worker's "failure to show that he was retired under the Plan, despite their failure to articulate a legitimate rationale, was not arbitrary and capricious."
Court: USDC Middle District of Tennessee , Judge: Trauger, Filed On: March 1, 2024, Case #: 3:21cv757, NOS: Other Contract - Contract, Categories: employment, erisa, Labor / Unions
J. Melgren grants a former employee's motion for summary judgment concerning an insurance company's denial of disability benefits under ERISA. The former employee, who developed a serious back pain condition at work, sufficiently showed in court that he was disabled while under the plan before he lost his job.
Court: USDC Kansas, Judge: Melgren, Filed On: February 14, 2024, Case #: 2:23cv2054, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Insurance
J. Shubb finds for a life insurance company on a widow’s ERISA claims arising from the denial of accidental death benefits when her husband, who was employed by a grocery store chain and was learning to fly allegedly store-owned aircraft, died following a fatal crash. The company's policy included an aircraft exclusion that applied to the decedent, as he was considered part of the crew, rather than a passenger, at the time of the accident.
Court: USDC Eastern District of California, Judge: Shubb, Filed On: January 26, 2024, Case #: 2:23cv919, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Insurance
J. Evanson finds in favor of the employer for its lawsuit seeking to enforce a Subrogation and Right of Recovery provision of its health benefits plan in order to recover a portion of the former employee's settlement funds equal to the medical benefits the employer paid out after the employee was injured in a car accident. The employer is entitled to a $73,300 judgment and attorney fees, because while the employee argues that it would be unfair to let the employer make itself whole through reimbursement because she was not made whole in her settlement of the New York action, its Health and Welfare Plan explicitly states that the employer's right to reimbursement trumps her right to be made whole.
Court: USDC Western District of Washington, Judge: Evanson, Filed On: January 18, 2024, Case #: 2:20cv1551, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Settlements
J. Zilly denies the employee's motion to amend the judgment for her complaint that the insurance company wrongfully denied her claim for long-term disability benefits under an employee benefit plan. The employee shows a taxable 2015 income of $104,500 but she does not show that this income is solely from her employment, or that it was her base salary without added funds such as bonuses and overtime pay. The insurance company is to calculate the employee's claim for LTD benefits according to the policy, and then it is to pay pre-judgment interest at a 5.46% rate per annum on unpaid LTD benefits from Oct. 6, 2020 until Oct. 6, 2023, the date of judgment.
Court: USDC Western District of Washington, Judge: Zilly, Filed On: December 18, 2023, Case #: 2:21cv1424, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Insurance
J. Cogburn grants an automobile association’s motion for summary judgment following wrongful denial of severance benefits allegations brought by a former vice president of talent development. The association recruited the VP to work internally in HR, which was a specialty of hers. However, after she relocated her family from Charlotte to San Antonio for the job, the association allegedly assigned her tasks vastly different than the ones they had initially discussed. After switching her job positions twice during her six weeks of employment, the association fired her. According to the severance plan, the VP was not qualified to receive any because it fired her due to negative job performance, which does not qualify for severance.
Court: USDC Western District of North Carolina, Judge: Cogburn, Filed On: September 27, 2023, Case #: 3:22cv146, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa
J. Atchley denies the individual plaintiff'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 allegedly injured in a motor vehicle accident, and the insurance provider eventually closed her claim when it determined that she could perform less physically demanding work. The company had "a reasoned basis" for its decision, including the opinions of several of the claimant's treating physicians.
Court: USDC Eastern District of Tennessee , Judge: Atchley, Filed On: September 22, 2023, Case #: 1:20cv266, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Insurance
J. Darrow grants an employee's motion for partial summary judgment for unpaid contributions under E.R.I.S.A. The employee sufficiently showed in court that her employer is obligated to pay delinquent contributions, interest, and liquidated damages.
Court: USDC Central District of Illinois, Judge: Darrow, Filed On: September 22, 2023, Case #: 4:18cv4045, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: employment, erisa, Labor / Unions
J. Richardson finds the lower court properly held that money was not one of the benefits that the mother's son was due under the terms of the employer-based health benefits program. The son, suffering from a rare heart disease, was denied the money needed to try an experimental heart transplant and died before his appeal of the denial was processed. The Employee Retirement Income Security Act allows plaintiffs to seek reimbursement for money spent on procedures but does not authorize a plaintiff to seek the monetary cost of a benefit that was never provided. Affirmed in part.
Court: 4th Circuit, Judge: Richardson, Filed On: September 11, 2023, Case #: 21-2207, Categories: employment, erisa, Health Care