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Insurance & ERISA Litigation Blog
Disability Policy Discretionary Clauses Come Under Congressional Attack
Policyholder/Employee groups who have group disability insurance coverage through their employers and who find themselves operating in the byzantine world of ERISA have long criticized discretionary clauses contained in such…
New Regulations Aim at Policy Rescissions
Insurance Commissioner Steve Poizner has announced new regulations that go into effect aimed at combating improper rescissions by insurance companies. These will go into effect on August 18, 2010. Poizner…
The Waiver Doctrine, Alive And Well in ERISA Cases
The Wednesday August 11, 2010 edition of the Los Angeles Daily Journal featured my article, entitled “The Waiver Doctrine, Alive And Well in ERISA Cases,” in the Perspective column. It explains a…
New Appeal Regulations For Health Plans Require Final Claims Decision To Be Made By External Reviewer
The Department of Health and Human Services issued new appeal regulations under the recently enacted Patient Protection and Affordable Care Act (“Affordable Care Act”). These regulations give claimants the right…
Ninth Circuit Applies New Hardt Decision to Deny ERISA Participant Attorney’s Fees
Last month, the U.S. Supreme Court handed ERISA plan participants a big victory when they decided the important ERISA disability case of Hardt v. Reliance Standard Life Insurance, __ U.S….
District Court Provides Additional Guidance on Scope of Discovery Under Glenn
In the last several years, the scope of discovery in ERISA cases has been a point of contention between plaintiff and defense counsel. Plaintiffs typically want free range to conduct discovery…
Submission of the Claim File: Seal or Redact?
For most insurance litigation, the majority of the evidence used by both sides comes from the claim file, also known as the administrative record in ERISA cases. The claim file…
U.S. Supreme Court Hands ERISA Plan Participants Major Victory in Allowing Recovery of Attorneys’ Fees
As predicted in my April blog post, the U.S. Supreme Court today handed ERISA plan participants a big victory when they decided the important ERISA disability case of Hardt v….
Insurance Commissioner Announces Examination of Anthem’s Claims-Related Data
Insurance Commissioner Steve Poizner announced last week that his office will conduct an examination of Anthem Blue Cross’s claims-related data used by Anthem to justify its future rate filings. This…
Two Major California Health Insurers to Cease Practice of Policy Rescissions
For several years, health insurers have been strongly criticized for engaging in post claim underwriting and improper policy cancellations, known in the law as “rescissions.” The Insurance Commissioner has even…
