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Documents Reviewed by Independent Medical Examiner Sufficient to Satisfy Plan Obligation to Consider All Relevant Documents
The United States Court of Appeals for the Ninth Circuit, in an unpublished decision, addressed the question of whether documents reviewed by an independent medical examiner, but not by the…
New California Health Insurance Legislation Moves Forward
The debate over national health care reform has moved to the California Legislature, which will begin taking the initial steps to implement the complex series of health insurance overhauls prescribed…
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….
Differential Standard of Review in ERISA Cases Clarified
The Tuesday May 4, 2010 edition of the Los Angeles Daily Journal featured my article, entitled “Deferential Standard of Review in ERISA case Clarified,” in the Perspective column. It explains…
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…
What Does a Deferential Standard of Review Mean in ERISA Cases? The U.S. Supreme Court Gives Some Clarification
The federal courts have for a long time struggled with how to apply the deferential standard of review to actions taken by ERISA plan administrators in light of the United…
U.S. Supreme Court Hears Oral Arguments in Hardt v. Reliance Standard Life Insurance: Under What Circumstances Can a Court Award Attorneys’ Fees in ERISA Actions?
The U.S. Supreme Court heard oral arguments yesterday in the important ERISA disability case of Hardt v. Reliance Standard Life Insurance (09-448). In that case, Bridget Hardt filed suit, arguing…
Reasonable Reliance on Erroneous SPD Needed to Establish Entitlement to Additional ERISA Benefits
What happens when an ERISA plan provides for a certain level of benefits and the required summary plan description (“SPD”) given to plan participants provides for greater benefits? The District…
Right to Jury Trial Trumps Binding Arbitration When Insurer Unreasonably Delays Paying Independent Defense Counsel
In an article appearing in the April 12, 2010 editions of the Los Angeles and San Francisco Daily Journals, I discuss the impact of the California Fourth Appellate District’s Intergulf…
