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Rulings, filings, and settlements of interest
- Proskauer Rose LLP
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- USA
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- November 9 2012
In Access Mediquip, L.L.C. v. UnitedHealthcare Insurance Co., F.3d , No. 10-20868, 2012 WL 4747260 (5th Cir. Oct. 5, 2012), the Fifth Circuit, en banc, held that ERISA does not preempt a third-party medical provider's state law claims based on a health plan insurer's misrepresentations of coverage
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
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- USA
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- October 12 2012
In Reese v. CNH Am. LLC, Nos. 11-1359, 11-1857, 11-1969, --- F.3d ---, 2012 WL 40009695 (6th Cir. Sept. 13, 2012), the Sixth Circuit for the second time reversed the decision of the district court and held that an employer could reasonably yet unilaterally alter lifetime healthcare benefits for retirees without engaging in collective bargaining
Sixth Circuit distinguishes itself and rules that presumption of prudence should not be applied on a motion to dismiss
- Proskauer Rose LLP
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- USA
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- February 23 2012
The Sixth Circuit issued a ruling on February 22, 2012 in Pfeil v. State Street Bank and Trust Co., No. 10-2302, 2012 WL 555481 (6th Cir. Feb. 22, 2012) that distinguishes itself from other Circuit Courts concerning the application of the presumption of prudence that applies to an ERISA plan fiduciary's decision to invest in an employer stock fund
Third Circuit limits relief available to ERISA welfare plans seeking reimbursement of medical expenses
- Proskauer Rose LLP
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- USA
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- November 17 2011
In a case of significant importance for plan sponsors and fiduciaries, the U.S. Court of Appeals for the Third Circuit held in US Airways, Inc. v. McCutchen, No. 10-3836 (3d Cir. Nov. 16, 2011), that an employee benefit plan was not entitled to full reimbursement of medical expenses it paid to a participant even though the plan provided that the participant was required to reimburse the plan for all amounts paid "out of any monies recovered from a third party."
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
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- USA
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- October 5 2011
In Franco v. Connecticut General Life Ins. Co., No. 07-cv-6039, 2011 U.S. Dist. LEXIS 109022 (D.N.J. Sept. 23, 2011), plaintiffs, who were plan subscribers, health care providers, and several associations whose members consisted of out-of-network ("ONET") providers who provided ONET services to patients insured by CIGNA, alleged that CIGNA violated its contractual obligations to pay for ONET services at the "usual, customary and reasonable" ("UCR") rate by relying on the flawed database maintained by Ingenix, which generated artificially low UCRs to underpay ONET benefits to CIGNA plan members
Rulings, filings, and settlements of interest
- Proskauer Rose LLP
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- USA
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- September 9 2011
In Florida v. United States Dep't of Health and Human Servs., 11-11021-cv, 2011 WL 3519178 (11th Cir. Aug. 12, 2011), the Eleventh Circuit affirmed in part and reversed in part the district court's ruling that the Affordable Care Act was unconstitutional
Proskauer is perspective
- Proskauer Rose LLP
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- USA
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- January 13 2011
Our look back at the past year, and forward into the coming year, confirms the enduring nature of ERISA litigation practice
Rulings, filings and settlements of interest
- Proskauer Rose LLP
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- USA
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- December 10 2010
In North Cypress Med. Ctr. Operating Co. v. MedSolutions Inc., No. 4:10-cv-2608 (S.D. Tex. Nov. 11, 2010), a district court held that a hospital lacked standing to sue a third-party claims administrator because the hospital’s patients had not made an express and knowing assignment of their rights to assert ERISA fiduciary duty claims against the hospital
Rulings, filings and settlements of interest
- Proskauer Rose LLP
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- USA
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- November 3 2010
In Matschiner v. Hartford Life & Accident Ins. Co., 2010 WL 3910217 (8th Cir. Oct. 7, 2010), the Eighth Circuit applied the “plan documents rule” established by the Supreme Court in Kennedy v. Plan Administrator for DuPont Savings & Investment Plan, 129 S.Ct. 865 (2009), and concluded that Hartford properly paid benefits pursuant to a beneficiary designation form rather than a Nebraska state divorce decree that purported to divest the decedent’s ex-husband of his right to the benefits
Rulings, filings and settlements of interest
- Proskauer Rose LLP
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- USA
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- October 13 2010
In Brown v. Owens Corning Investment Review Committee, 2010 WL 3730918 (6th Cir. Sept. 27, 2010), the Sixth Circuit affirmed dismissal, on statute of limitations grounds, of plaintiffs' claims against plan fiduciaries arising from employer stock holdings in two Owens Corning retirement plans
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- Workarea - Employee Benefits & Pensions
- Author - Robert Rachal
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