In Graham v. Hartford Life & Accident Ins. Co., 2009 U.S. App. LEXIS 28550 (December 29, 2009), the Tenth Circuit determined that ERISA governed a plan established by the National Rural Letter Carriers Association, the exclusive collective bargaining representative, because the United States Postal Service did not establish the Plan or contribute payments to it,...Read More

Rasenack v. AIG Life Ins. Co., 585 F.3d 1311. The Tenth Circuit, by contrast to the Ninth Circuit, held that ERISA preempts the Utah insurance regulation prohibiting discretion-granting clauses in ERISA plans except in certain plans with specific “safe harbor” language. Hancock v. Metropolitan Life Ins. Co., 2009 U.S. LEXIS 28545 (December 29, 2009).Read More

On September 30, 2009, the Tenth Circuit, in Salisbury v. Hartford Life and Accident Ins. Co., 583 F.3d 1245 upheld a district court’s determination that the contractual suit limitations provision in an ERISA Plan barred a claim for benefits. On November 2, 2009, the Tenth Circuit remanded a case involving accidental paralysis and rehabilitation benefits...Read More

In Holcomb v. Unum Life Ins. Co., 578 F.3d 1187 (August 11, 2009), the Tenth Circuit commented that theGlenn decision abrogated the Tenth Circuit’s previous approach to evaluating conflicts of interest in which it shifted the burden to the administrator to establish by substantial evidence that the denial of benefits was not arbitrary and capricious...Read More

In Cooper v. Hewlett-Packard Co., 2009 LEXIS 27640 (December 16, 2009), the Fifth Circuit found that Glenndid not apply to that case because the payor of the Plan employed a contract administrator to evaluate claims, stating that Glenn only applies when the administrator has a conflict of interest-where the plan administrator both evaluates and pays...Read More

In Swanson v. Hearst Corporation Long Term Disability Plan, 586 F.3d 1016 (November 3, 2009), the Fifth Circuit upheld the ERISA Plan’s failure to exhaust administrative remedies affirmative defense when the claimant failed to timely submit evidence on her appeal, finding a letter sent within the appeal period advising the Plan of the intention to...Read More

In Holland v. International Paper Company Retirement Plan, 576 F.3d 240 (July 16, 2009), the Fifth Circuit found that while the employer’s funding of a trust to pay benefits and its employee’s roles as plan administrator created a conflict, the conflict was not a significant factor, because the contributions were irrevocable and a decision to...Read More

The unpublished decision of Chellino v. Kaiser Foundation Health Plan, Inc., 2009 LEXIS 24350 (November 5, 2009) further illustrates how the Ninth Circuit is likely to apply Glenn to benefits decisions. As with Montour, the Ninth Circuit found an abuse of discretion in connection with a fibromyalgia claim. Among other factors the Ninth Circuit pointed...Read More

Standard Ins. Co. v. John Morrison, 584 F.3d 837 (October 27, 2009). This case is likely to have a far-reaching impact as a number of Insurance Commissioners have stated their intention to deny any application for an insurance policy containing discretionary language, including California’s Insurance Commissioner.Read More

Scharff v. Raytheon Company Short Term Disability Plan, et. al, 581 F.3d 899 (September 9, 2009). Importantly, in Scharff, the Ninth Circuit declined to import into ERISA federal common law a California insurance regulation which imposes a duty to inform claimants of statutory deadlines. In a decision that is likely to have serious ramifications, in...Read More