tag:blogger.com,1999:blog-100170572024-03-07T00:51:55.804-08:00Florida ERISA BlogThis is a weblog devoted to recent developments in ERISA and employee benefits law in Florida. Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-10017057.post-75041897289131780182013-06-25T13:23:00.001-07:002013-06-25T13:23:07.344-07:00Lessons From The Howard Case<div class="MsoNormal" style="text-align: justify;">Last year I had the opportunity to attend a gathering of many of the ERISA litigators in Florida, both plaintiff and defense. One of the hot topics at that conference was a case known as <u>Howard v. Hartford Life & Accident Insurance Co.</u> which was possibly going to be the vehicle for the Eleventh Circuit to clarify the rules of discovery in ERISA cases. That never really happened. Nonetheless, the district court recently decided the case on the merits in favor of Hartford. It is still an important read.</div><div class="MsoNormal" style="text-align: justify;"><br />
</div><div class="MsoNormal" style="text-align: justify;">Like so many ERISA LTD cases, the plaintiff claimed fibromyalgia as a primary disabling condition. As often happens in these cases, the plaintiff was placed under video surveillance. Just as commonly, consulting doctors were retained who were shown portions of the video depicting, in the court’s opinion, the plaintiff doing far more than she claimed possible. The district court ultimately ordered summary judgment in Hartford’s favor. Plaintiffs and their attorneys have several lessons to learn from <u>Howard</u>…</div><div class="MsoNormal" style="text-align: justify;"><br />
</div><div class="MsoNormal" style="margin-right: .5in; text-align: justify;"></div><ul><li>Video surveillance can kill an ERISA case. That is exactly what happened in <u>Howard</u>. Within the opinion there is a debate over the meaning of “objective medical evidence”. In the court’s opinion the best evidence was the video which showed the plaintiff doing far more than subjectively complained of.</li>
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</div><div class="MsoNormal" style="margin-right: .5in; text-align: justify;"></div><ul><li>Plaintiff’s attorneys cannot simply count on a bare conflict of interest without more to show that the carrier’s conduct was arbitrary and capricious. Neither can one rely upon simply showing that the defendant’s employee received bonuses and company stock or were aware of case reserves.</li>
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</div><div class="MsoNormal" style="margin-right: .5in; text-align: justify;"></div><ul><li>Counsel must strictly adhere to the technical page limitation, footnote and font rules. The judge’s considerable aggravation about plaintiff’s counsel’s violation of those rules did not help the plaintiff’s cause.</li>
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<div class="MsoNormal" style="text-align: justify;">These are never easy cases and they are made only difficult, if not impossible to win, when damaging surveillance is involved. It is imperative to determine whether it exists and review it carefully before filing suit. </div>Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-11490948950864420292013-05-21T07:13:00.001-07:002013-05-21T07:20:22.879-07:00A Great Resource Book<br />
I recently had the opportunity to review PLI's ERISA Litigation Answer Book 2013.<br />
<br />
If you're new to ERISA litigation and need a quick overview of the landscape or need a handy desk reference this is a great resource. The Q and A format combined with footnoting rather than embedding the cites in the main text makes it easy to read.<br />
<br />
<a href="http://www.pli.edu/Content/Answerbook/ERISA_Benefits_Litigation_Answer_Book_2013/_/N-b8Z1z130yi" target="_blank">Check it out here</a>Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-62301618664695487812013-05-06T09:36:00.001-07:002013-05-06T09:39:28.500-07:00ERISA Liens: Big As Ever<!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Template>Normal.dotm</o:Template> <o:Revision>0</o:Revision> <o:TotalTime>0</o:TotalTime> <o:Pages>1</o:Pages> <o:Words>251</o:Words> <o:Characters>1434</o:Characters> <o:Company>Haas & Castillo, PA</o:Company> <o:Lines>11</o:Lines> <o:Paragraphs>2</o:Paragraphs> <o:CharactersWithSpaces>1761</o:CharactersWithSpaces> <o:Version>12.0</o:Version> </o:DocumentProperties> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:Zoom>0</w:Zoom> <w:TrackMoves>false</w:TrackMoves> <w:TrackFormatting/> <w:PunctuationKerning/> <w:DrawingGridHorizontalSpacing>18 pt</w:DrawingGridHorizontalSpacing> <w:DrawingGridVerticalSpacing>18 pt</w:DrawingGridVerticalSpacing> <w:DisplayHorizontalDrawingGridEvery>0</w:DisplayHorizontalDrawingGridEvery> <w:DisplayVerticalDrawingGridEvery>0</w:DisplayVerticalDrawingGridEvery> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:DontGrowAutofit/> <w:DontAutofitConstrainedTables/> <w:DontVertAlignInTxbx/> </w:Compatibility> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="276"> </w:LatentStyles> </xml><![endif]--> <!--[if gte mso 10]> <style>
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In my last blog post I overviewed the opposing arguments heard by the Supreme Court in <u>U.S. Airways v. McCutchen</u>. On April 16, 2013 the court handed down its decision: one clearly favorable to health insurance carriers seeking reimbursement of benefits paid from tort recoveries. </div>
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Recall that the application of the “unjust enrichment” and “common fund” doctrines in reimbursement cases was before the court. A unanimous court ruled that the unjust enrichment doctrine was ineffective to reduce a carrier’s reimbursement claim. Justice Kagan’s opinion held that a health insurance carrier’s right of reimbursement arises as a matter of contract and is enforceable as the modern-day equivalent of an equitable lien by agreement. </div>
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<br /></div>
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Apart from the question of whether the unjust enrichment doctrine applied to bar or reduce the carrier’s claim, the court also answered the question of whether the “common fund” doctrine could serve to offset the carrier’s claim to the extent the tort claimant’s attorney was entitled to a contingency fee. Since the U.S. Airway’s health insurance plan did not contain language barring the application of the common fund doctrine the court held that it was applicable - McCutchen's lien was thus proportionately reduced. This, of course, was a fact-specific result with an implicit message to carriers to add the appropriate language to avoid the "problem" in the future.</div>
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<br /></div>
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So, not only is the 800-pound gorilla <u>not</u> going on a diet, he is bigger and more powerful than ever. Personal injury practitioners must recognize that ERISA liens are super liens and must factor this into the intake analysis. Practitioners will need to make early contact with the health insurance carrier to persuade it that but for the tort action no recovery whatsoever may be had. At least this logic may still hold some weight. </div>
<!--EndFragment-->Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-24948854998686546492013-01-17T08:55:00.003-08:002013-01-17T08:55:20.315-08:00ERISA Liens: Is the "800 Pound Gorilla" About To Go On A Diet?
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Most personal injury attorneys
undoubtedly view ERISA liens arising out of group health insurance payments as
the “800 pound gorilla” that can gut a client’s recovery or indeed dissuade a
lawyer from taking a case in the first place. The conventional wisdom, backed
up by more than adequate authority, is that ERISA liens are so-called “super
liens” entitled to precedence over a personal injury plaintiff’s own recovery.
Whether ERISA liens will continue to be as “super” in the future is a question
now before the U.S. Supreme Court. The outcome may change the landscape of
personal injury litigation.</div>
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<br /></div>
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The case before the court, <u>U.S.
Airways v. McCutchen</u>, is a case that originated in federal court in
Pennsylvania and later was appealed to the Third Circuit Court of Appeals. The
plaintiff in <u>McCutchen</u> pursued damages arising out of a motor vehicle
accident ultimately recovering $110,000. McCutchen and his attorney agreed to a
40% contingency fee resulting in a $44,000 fee out of the gross recovery
netting McCutchen $66,000. Here was the problem: McCutchen’s medical benefits
plan paid $66,866 in medical expenses thereby eliminating any recovery to him
whatsoever. When the plan sponsored by McCutchen’s employer, U.S. Airways,
demanded payment of the full sum out of the tort recovery, <u>McCutchen’s</u>
attorney refused arguing that it would be unfair and inequitable to reimburse
the plan in full when McCutchen had not been fully compensated for his injuries
and the plan, which made no contribution to attorney’s fees and expenses, would
be unjustly enriched were it permitted to recover without any allowance for
those costs. </div>
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<br /></div>
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U.S. Airways filed suit in
federal district court seeking recovery of the full $66,866. In support of its
argument for recovery U.S. Airways noted plan language specifically authorizing
reimbursement in the amount of benefits paid out of “<u>any</u> recovery”. It
also pointed to case authority that had previously rejected equitable theories
for reducing a lien recovery. The district court ruled in the plan’s favor and
entered judgment against McCutchen.</div>
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On appeal the equitable nature of ERISA liens was brought
into sharper focus. Prior Third Circuit precedent had allowed health insurance
plans seeking reimbursement to ignore equitable arguments in favor of reducing
the lien amount. The <u>McCutchen</u> panel reviewed those cases against the
backdrop of more recent Supreme Court authority clarifying the meaning of
“appropriate equitable relief” in ERISA reimbursement cases. The Circuit Court
reasoned that if the plan had the power to seek appropriate equitable relief
then the full range of equity principles, including those favoring a plaintiff,
were in play as well. It reversed the District Court’s judgment and remanded
the case for the District Court to consider the application of such principles
to the case.</div>
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<br /></div>
<div class="MsoBodyText">
In what will now be a string of Supreme Court
pronouncements on what exactly “appropriate equitable relief” means the court
took certiorari and recently heard oral argument in the <u>McCutchen</u> case.
The exchange between counsel and the court at oral argument reflects three
possible outcomes. First, the court could rule in blanket fashion that
equitable principles such as unjust enrichment, the common fund doctrine or the
make whole doctrine apply in all ERISA lien cases. Conversely, the court could
rule that plaintiff-favorable principles never apply. The third approach would
look to the specific language of the plan document to see if the equity
principles in question were addressed. Several of the justices at oral argument
noted that U.S. Airways’ plan language might not have been clear enough to give
its lien precedence. That could be the basis for a holding limited to the facts
that could be favorable for Mr. McCutchen but unfavorable where plan drafters
have drafted broad lien rights. I personally view this as the most likely
outcome.</div>
<div class="MsoBodyText">
<br /></div>
<div class="MsoBodyText">
In the next several months pending the court’s decision I
think plaintiff’s attorneys have an opening in negotiations with ERISA lien
holders to argue that the lien should be reduced at least by the amount of the
contingent attorney fee. Counsel could suggest that a very plaintiff-favorable
ruling in <u>McCutchen</u> could lead to “make whole doctrine” arguments that
could serve to eliminate liens completely. Yes, it is just an argument, but one
well-informed counsel trying to maximize their clients recovery should consider
making.</div>
<!--EndFragment-->Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-18541697850853344102012-12-10T09:07:00.001-08:002012-12-11T06:05:40.436-08:00More on the Amara Case<!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Template>Normal.dotm</o:Template> <o:Revision>0</o:Revision> <o:TotalTime>0</o:TotalTime> <o:Pages>1</o:Pages> <o:Words>421</o:Words> <o:Characters>2403</o:Characters> <o:Company>Haas & Castillo, PA</o:Company> <o:Lines>20</o:Lines> <o:Paragraphs>4</o:Paragraphs> <o:CharactersWithSpaces>2951</o:CharactersWithSpaces> <o:Version>12.0</o:Version> </o:DocumentProperties> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:Zoom>0</w:Zoom> <w:TrackMoves>false</w:TrackMoves> <w:TrackFormatting/> <w:PunctuationKerning/> <w:DrawingGridHorizontalSpacing>18 pt</w:DrawingGridHorizontalSpacing> <w:DrawingGridVerticalSpacing>18 pt</w:DrawingGridVerticalSpacing> <w:DisplayHorizontalDrawingGridEvery>0</w:DisplayHorizontalDrawingGridEvery> <w:DisplayVerticalDrawingGridEvery>0</w:DisplayVerticalDrawingGridEvery> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:DontGrowAutofit/> <w:DontAutofitConstrainedTables/> <w:DontVertAlignInTxbx/> </w:Compatibility> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="276"> </w:LatentStyles> </xml><![endif]--> <!--[if gte mso 10]> <style>
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In my previous post I briefly discussed the U.S. Supreme Court’s 2011 decision in <u>Cigna Corp. v. Amara</u>. The question in that case was the scope of relief available under Section 502(a)(1)(B) compared to Section 502(a)(3) of ERISA. “Garden variety” ERISA benefit cases are brought under Section 502(a)(1)(B) and seek <u>enforcement</u> of the terms of a plan. For instance, a plaintiff wrongfully denied long-term disability insurance benefits seeks to enforce the terms of the plan providing benefits to a totally disabled plan participant. In <u>Amara</u> the plaintiff class alleged misrepresentations regarding the effect of a defined benefits to cash balance pension plan conversion. The Supreme Court held that Section 502(a)(1)(B) was an inappropriate vehicle to conform the benefits to what plan participants and beneficiaries expected. This was the “victory” gained by Cigna.</div>
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<br /></div>
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The problematic portion of the decision for Cigna was the court’s “guidance” to the district court on remand. The court observed <i>in dictum</i> (but probably persuasive <i>dictum</i> at that) that the court could award the requested relief pursuant to Section 502(a)(3). The court foresaw three theories of possibly viable equitable relief upon remand: equitable estoppel, reformation and surcharge. Equitable reformation under Section 502(a)(3) would require detrimental reliance by plan participants. A showing of detrimental reliance would not be required for reformation based upon fraudulent supression, omission or an insertion materially affecting the contract. Nor would detrimental reliance be required for surcharge based on a trustee’s breach of duty. Futher, the court observed that a remedy based upon the failure to provide complete and accurate information in summary plan descriptions and summaries of material modification would require only a showing of actual harm and causation, not detrimental reliance. </div>
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<br /></div>
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One of the cornerstones of ERISA litigation is the notion that ERISA law is based in equity (as is the general body of trust law). Consequently, most practitioners would say that money damages are not available in ERISA cases. The <u>Amara</u> decision is the latest in a series of decisions that has blurred the distinction between money damages at law and equitable relief. A surcharge, for instance, is going to look and feel like a money damage award to a party that has to pay it.</div>
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<br /></div>
<div class="MsoNormal" style="text-align: justify;">
The scope of equitable relief available under ERISA is one of the hottest topics in ERISA litigation. Another setting where the scope of remedies is playing out is an ERISA plan’s right to equitably subrogate against a personal injury settlement: one of the most important considerations in any personal injury case where an employee’s health plan has paid for a portion or all of the medical care. In my next blog post I will explore <u>U.S. Airways v. McCutchen</u> a pending case where the Supreme Court will again address the limits of equitable relief.</div>
<!--EndFragment-->Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-88764111685876457412012-10-26T12:21:00.003-07:002012-10-26T12:21:54.762-07:00Back in Blog<br />
Yes, it has been a LONG time. Family health challenges have focused attention on the practice…and my family. But I am back. And a LOT has happened.<br />
<br />
Let’s begin with the recent past. For years the courts have struggled with the meaning of “appropriate equitable relief” in ERISA cases. Last year the U.S. Supreme Court handed down <u>Cigna Corp. v. Amara</u>, a case with far-reaching implications on the “equitable relief” front.<br />
<br />
The plaintiffs in Amara brought suit under both Sections 502(a)(1)(B) and 502(a)(3) of ERISA. The former authorizes suits to enforce the right to plan benefits, the latter authorizes actions for equitable relief. The plaintiffs’ claimed that the defendants misled them in the description of benefits that would be available after a pension plan was converted to a cash balance plan. The plaintiffs presented evidence, in the form of statements contrary to plan terms, showing the employer had deliberately failed to educate plan participants about their post-transition cash balances.<br />
<br />
The district court ruled in the plaintiff’s favor holding that the defendants “representations have become terms of the plan” and ordered the plan to calculate benefits under the modified terms. The Second Circuit affirmed the district court’s opinion on appeal.<br />
<br />
The Supreme Court handed the defendants a pyrrhic victory holding that the plaintiff’s claims could not be stated under Section 502(a)(1)(B). Nonetheless, seven of the nine Justices (all but Scalia and Thomas) held open the possibility that the plaintiff’s claims could be stated under Section 502(a)(3). The case was remanded to the district court for further proceedings. The court observed that appropriate “equitable relief” under Section 502(a)(3) could include reformation, estoppel and “surcharge” i.e. monetary compensation.<br />
<br />
In my next post I will explore the implications of this holding in more detail. I am glad to be back.<br />
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Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1113226647025512842005-04-11T09:36:00.000-07:002005-04-11T06:37:27.026-07:00New 11th Circuit Fiduciary Duty CaseThe scope of ERISA’s fiduciary duties was recently analyzed by the Eleventh Circuit in Cotton v. Massachusetts Mutual. The plaintiffs in Cotton accused the carrier of misrepresentation, fraud and promissory estoppel and sought equitable relief requiring that certain life insurance policies perform as described in a whole life policy presentation. The District Court in this case, while rejecting a benefits claim as well as promissory estoppel and individualized fiduciary breach relief, held that the defendants had violated ERISA fiduciary duties entitling the plan to overall relief. The Circuit Court’s reversal focused on the insurer’s role as an alleged fiduciary. Although the carrier had conceded it was a fiduciary for the purpose of making death benefit determinations, it maintained that the plaintiffs had failed to establish that it was a fiduciary for any other purpose. The court agreed. The court noted that “simply urging the purchase of (insurance) products does not make an insurance company an ERISA fiduciary with respect to those products.” Thus it is important to consider not only the scope of ERISA’s fiduciary duties but also the role of the players in a plan, with an emphasis upon whether they truly perform fiduciary duties.Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1109969770295203722005-03-04T16:00:00.000-08:002005-03-04T12:56:10.296-08:00The Heightened Arbitrary and Capricious StandardLong time no blog – got a bit behind with a 2-week flu bug and the game of catch up that followed.<br /><br />As I previously suggested the “standard of review” can drive the ultimate outcome in an ERISA benefits case. Many close cases involve the so-called “heightened arbitrary and capricious” standard of review. This is where the plan decision maker, although protected by discretion-granting language in the plan document, operated under a conflict of interest. The 11th Circuit has taken the position that a “poisoning of the well” should be presumed in such instance and deference to the plan reduced or eliminated. All kinds of interesting issues crop up in these cases. A recent decision out of the Southern District, <em>Fick vs. Met Life</em>, is particularly interesting on the issue of the evidence that can be considered by the Court. <br /><br />The <em>Fick Court</em> held that relevant evidence outside the claims file could include: 1) the technical competence of the claims decision maker, 2) the exact nature of the information considered by the decision maker and 3) the routine claims practices followed in reaching the decision. So far so good for claimants who seek discovery. But the Court held that the plan overcame the burden against it by showing that it enlisted the help of two independent case evaluators and objectively considered all of the claimant’s evidence.<br /><br />Here’s what bothers me about this opinion: it pays homage to 11th Circuit case law which underscores the dangers of the taint caused by a conflict of interest but then too easily forgives it. Plans routinely use consultants to deny claims. Does that “routine practice” justify giving them a hall pass? 11th Circuit case law gives plans the opportunity to overcome the taint by showing that their decision was in the overall best interests of plan participants and beneficiaries. This, in my opinion, is a heavier burden.Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1107472001984522402005-02-03T18:06:00.000-08:002005-02-03T15:09:07.920-08:00ERISA SeminarIf you're interested in a general ERISA overview seminar consider attending the Labor and Employment Law Section's Certification Review Course in Orlando. I'll be giving a presentation entitled "ERISA / COBRA". You can find the brochure <a href="http://www.laboremploymentlaw.org./pdf/CLE_cert_review0202R_2005.pdf">here</a>.
<br />Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1106753136266078172005-01-26T10:25:00.000-08:002005-01-26T07:25:36.266-08:00Standards of Review 101The standard of review in a benefits case often drives the outcome. This was illustrated in a recent Middle District opinion: <em>Dowling v. Metropolitan Life Insurance Co.</em> Courts recognize three standards of review. The “pure arbitrary and capricious” standard of review is highly deferential to the Plan. The “heightened arbitrary and capricious” standard of review governs where the claims decision maker operated under a conflict of interest. Under Eleventh Circuit precedent, it is presumed that this conflict infected the decision unless the decision maker can show otherwise. Thus, less deference is given to the Plan under this standard. Finally, the “de novo” standard of review gives no deference to the Plan. Which standard governs depends on whether the Plan included adequate protective language in plan documents, as well as the afore-mentioned presence (or not) of a conflict of interest. More on this in a later post.
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<br />In <em>Dowling</em>, Judge Moody noted that the plaintiff’s own treating physicians were equivocal and that the defendant’s consultants found that he could perform sedentary work. The Court held that the pure arbitrary and capricious standard of review applied. Not surprisingly, the Court upheld the benefits denial.
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<br />Plaintiffs can win “pure arbitrary and capricious” cases but seldom if ever without the unequivocal help of the treating physicians.
<br />Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1106249826441712862005-01-20T11:29:00.000-08:002005-01-26T07:27:40.890-08:00The Unum SettlementERISA benefits litigators are well aware that Unum (and its various permutations, e.g., Unum Provident, First Unum, etc.) is the nation’s largest disability insurer. On November 18, 2004, New York State Attorney General Elliott Spitzer announced a landmark settlement with Unum resolving a multi-state investigation into alleged unfair claims-handling practices. The settlement requires Unum: (1) to reassess approximately 200,000 claims that previously had been denied; (2) to completely restructure its claims-handling procedures to ensure objectivity and fairness; and (3) to pay a 15-million-dollar fine.
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<br />The settlement will revive long denied claims including many that were clearly time barred. It will also give current litigants a shot at a remand to the plan. The ultimate outcome of all this “reassessment” is anyone’s guess.
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<br />The settlement agreements are worth a read. You can find them <a href="http://www.unum.com/settlementagreement/">here</a>.
<br />Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1106078212943002792005-01-18T14:56:00.000-08:002005-01-18T11:58:27.656-08:00Fees ... pleaseA recent decision out of the Southern District illustrates the attorneys’ fees analysis applicable to ERISA cases in Florida. Plaintiff’s counsel in <em>Smith v. Reliance Standard Life Insurance Company</em>, successfully prosecuted a claim for long-term disability benefits, recovering $319,200 in principal plus pre-judgment interest of $72,149.
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<br />In the Eleventh Circuit, five factors are considered in determining whether to award attorneys’ fees in an ERISA case:
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<br />1. The degree of the opposing party’s culpability or bad faith;
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<br />2. The ability of the opposing party to satisfy an attorneys’ fee award;
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<br />3. Whether an award of attorneys’ fees would deter similarly situated persons;
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<br />4. Whether the parties requesting fees sought to benefit all plan participants and beneficiaries or sought to resolve a significant legal question regarding ERISA; and
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<br />5. The relative merits of the parties’ positions.
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<br />The District Court found that two factors did not favor the award of fees: there was no evidence of bad faith, and Plaintiff’s claim did not resolve a significant legal question regarding ERISA. Nonetheless, the Court awarded fees.
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<br />This case reminds us that one need not have all five fee factors present to prevail on a fees’ claim. In fact, a prevailing plaintiff in a benefits action should typically be capable of showing the defendant’s ability to pay an award, the deterrence effect of the benefits award, and the obvious merit of the plaintiff’s position. It is worth additionally noting that the Court found $300 per hour reasonable.
<br />Marcus Castillohttp://www.blogger.com/profile/16664955024030918961noreply@blogger.comtag:blogger.com,1999:blog-10017057.post-1105133160175159962005-01-07T16:30:00.000-08:002012-11-30T14:17:13.537-08:00Welcome to My BlogLet me introduce myself. I'm <b><a href="http://www.haas-castillo.com/attorneys/marcus-castillo/" target="_blank" title="Read more about Florida ERISA attorney Marcus Castillo">Marcus Castillo, an ERISA attorney</a></b> with <b><a href="http://www.haas-castillo.com/" target="_blank" title="Read more about Florida law firm Haas-Castillo, P.A.">Haas-Castillo, P.A.</a></b> in Clearwater, Florida. <b><a href="http://www.haas-castillo.com/practice-areas/erisa/" target="_blank" title="Learn more about what an ERISA is at Florida law firm Haas-Castillo, P.A.">ERISA</a></b>, for those of you who may not know, is the federal law governing most group employee benefits. It's sort of a stealth law in the sense that most folks don't know much about it and won't unless they lose those benefits. Trust me - when those benefits are lost ERISA becomes very relevant to the unfortunate victim. My job is to help clients recover the benefits that were wrongfuly denied them. This may require the filing of an ERISA lawsuit in Federal Court.
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The mission of this web log aka blog is to be a resource regarding recent happenings in ERISA law as handed down in Florida and the Courts that govern Florida (including the 11th Circuit Court of Appeals in Atlanta as well as the U.S. Supreme Court). Since my practice is largely devoted to disability insurance claims I intend to pay particular attention to decisions in those type of cases.
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I welcome all comments and look forward to hearing from you.
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