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Insurance & ERISA Litigation Blog
Ninth Circuit Clarifies Application of Abuse of Discretion Review When Insurer Has a Conflict of Interest
After the United States Supreme Court decided MetLife Ins. Co. v. Glenn in which the Court held that a reviewing court must consider the conflict of interest arising from the…
Under Abatie, Discovery of Profitability Reports is Not Allowed
One of the most interesting questions in ERISA litigation is: What constitutes the administrative record for purposes of determining whether the administrator abused its discretion in making a claim determination? …
Health Care Provider Claims Against Employer Not Preempted by ERISA
In Marin General Hospital v. Modesto & Empire Traction Co., 581 F.3d 941 (9th Cir. 2009), the Ninth Circuit Court of Appeals held that section 502(a)(1)(B) of ERISA did not…
Will Healthcare Reform Affect the Rate of Claim Denials?
On Monday October 19, 2009, Lisa Girion of the Los Angeles Times reported on the healthcare reform bills being debated in Congress and their potential impact on claim denials by…
California’s 2009 Insurance Legislation: It Was an Important Year
2009 was an important year for insurance legislation in California. An excellent review of this legislation was posted on December 4, 2009 by the Barger & Wolen LLP legal blog…
California Insurance Commissioner Unveils Proposed Rescission Regulations
California Insurance Commissioner Steve Poizner unveiled his proposed regulations to, according to an LA Times article dated June 3, 2009, “combat the health insurance industry practice of dropping members with costly illnesses.” According…
Court of Appeal Complicates the Analysis of Mental and Nervous Disability Claims
Bosetti v. The United States Life Ins. Co., 175 Cal. App. 4th 1208 (2009) is an important California Court of Appeal decision that addressed whether a two-year benefits limitation on…
House Committee Votes to Strip Health Insurance Industry of Exemption from Federal Antitrust Laws
As reported by the Associated Press, a House committee has voted to strip the health insurance industry of its exemption from federal antitrust laws as senators announced plans to take the…
No More Gender Rating in California
The practice of paying different rates based on gender for the same insurance is called gender rating. Effective January 1, 2010, health insurance companies and HMO’s writing insurance in California will…
