Life, Health and Disability

The Life, Health and Disability Committee focuses on issues affecting the life insurance, health insurance, disability insurance and managed care industries. The Committee addresses a broad spectrum of issues, including underwriting, claims, regulatory and compliance matters, and ERISA issues. The Committee’s seminars are usually litigation-oriented, but also address relevant non-litigation issues as well. The Committee’s members consist of in-house attorneys and claims professionals for life, health and disability insurance companies and for managed care entities, as well as outside counsel who represent their interests. Our members are incredibly enthusiastic about the Committee, which provides practical advice, industry insight and legal support in the fast-changing and challenging environment in which this portion of the insurance industry currently finds itself.

The Committee has a number of Subcommittees, including Programs, Membership/Marketing, Publications, Webconferences, Web Page, Expert Witness, Legislative Liaison, State Liaison, Diversity Liaison, Public Relations, Young Lawyers and Special Projects.

The Committee presents a substantive seminar every April. The Committee views this seminar as one of its most important functions and works hard to ensure that it provides the substantive CLE material that will permit our members to practice effectively and efficiently in this field of the law. The Committee’s annual seminar has consistently received high marks from attendees, whose numbers have increased each year and whose feedback on topics and speakers have provided the foundation for each year’s agenda. Together, the Committee’s leadership and members have made this the one “mandatory” seminar for those practicing in the life, health and disability area. The agenda for the annual program is developed by an advisory committee, primarily made up of in-house insurance counsel. The 2007 and 2008 programs each drew nearly 500 attendees. The next Life, Health, Disability and ERISA Claims Seminar will be held April 22•24, 2009, in New York City. The Committee is also focusing on webconferences.

One of the greatest ongoing benefits of belonging to this Committee is receiving the Committee’s quarterly publication, Life, Health and Disability News. This newsletter is a wonderful resource for our members. The newsletter includes scholarly articles by leading practitioners in the field, a compendium of the latest legal developments, current ERISA case law analysis, and shorter articles providing readers with practical advice and fresh insights on cutting edge issues. The Committee encourages all members to contribute to the newsletter, and many do, which accounts for the scope and depth of the material contained in it. Overall, Life, Health and Disability News is the best place to go for the most up-to-date review of legal issues affecting the life, health and disability insurance industry. The Committee is also taking the lead in producing a periodic newsletter for all DRI members on ERISA issues.

E-News Flash

9th Circuit Split Decision on denial of Golden Gate Restaurant Association en banc Petition

Golden Gate Association involves a challenge on ERISA preemption grounds to a San Francisco law requiring all employers in the City to make mandatory contributions toward employee healthcare costs. The 9th Circuit reversed a District Court ruling that the law is preempted by ERISA. In denying Golden Gate's en banc rehearing petition eight Circuit Court Judges dissented from the court's decision not to rehear this matter en banc and issued a long opinion discussing why the majority is wrong. There's also a concurring opinion defending the majority's decision not to rehear the case. This decision creates a circuit split with the 4th Circuit's decision in Retail Industry Leaders v. Fielder case preemption issue holding that a Maryland state law imposing a similar employer mandate (albeit, only on employers of 10,000 or more employees in the state) was preempted by ERISA. Now that the Circuit Court denied rehearing, the matter is ripe for a petition for certiorari to the U.S Supreme Court.

Click here to view the case.

Sixth Circuit Upholds Michigan’s Discretionary Clause Ban

The Sixth Circuit held in American Council of Life Insurers, et. al v. Ross, Case No.08-1406 (March 18, 2009) that state insurance department prohibitions of discretionary clauses are not preempted by ERISA.

Click here to view the case.

Estate of Schwing - Third Circuit abandons "Sliding Scale"

Yesterday (4/14/09), the Third Circuit handed down the attached opinion concerning discretionary review post MetLife v. Glenn.  As you will see, in Point II of the opinion, the Circuit Court states, "... we find that, in light of Glenn, our 'sliding scale' approach is no longer valid."  The Third Circuit ruled that instead, courts reviewing administrators' decisions pursuant to ERISA 502(a)(1)(B) must "apply a deferential abuse of discretion standard of review across the board" and only consider conflict of interest as but one of several factors when deciding whether the administrator abused its discretion.

Click Here to view the case.

Denmark v. Liberty Life Assurance Company of Boston

In Denmark v. Liberty Life Assur. Co., the District Court in Massachusetts affirmed Liberty's denial of plaintiff's claim for long term disability benefits based on a fibromyalgia diagnosis.  A divided panel of the First Circuit affirmed the District Court's opinion.  See 481 F.3d 16 (1st Cir. 2007)(Denmark I).  Plaintiff moved for rehearing and the Court held off on ruling on the petition pending the Supreme Court's decision in Metropolitan Life Ins. Co. v. Glenn, 128 S. Ct. 2343 (2008).  Following Glenn, the First Circuit panel took additional briefing and held a second oral argument.

Click Here to view the entire summary and case.
 

Krolnik v. Prudential Ins. Co. of Am., No. 08-2616, 2009 U.S. App. LEXIS 13916 (7th Cir. June 29, 2009)

Approximately two years after holding in Patton v, MFS/Sun Life Financial Distributors, Inc., 480 F.3d 478, 490 (7th Cir. 2007), that the admission of discovery outside of the administrative record in ERISA de novo cases is within the sound discretion of the court, guided by the need of the court for additional evidence to render an informed decision, the Seventh Circuit yesterday revisited the issue of the scope of discovery under de novo review in Krolnik v. Prudential Ins. Co. of Am., No. 08-2616, 2009 U.S. App. LEXIS 13916 (7th Cir. June 29, 2009).

Click here to view more.

Recently the Second Circuit issued its decision in Hobson v. MetLife, 07-0364-cv,  __ F.3d __, 2009 WL 2245215 (2d Cir.(NY) July 29, 2009), which provided rulings on several important issues in controversy following the Supreme Court's decision in MetLife v. Glenn.  Among the important rulings included in this opinion are the following:

 

Click Here to view more

rss  

Links of Interest

Committee Chair

Brooks R. Magratten

Pierce Atwood LLP

(401) 588-5113
E-Mail: bmagratten@pierceatwood.com

Committee Vice-Chair

Ann-Martha Andrews

Lewis and Roca

(602) 262-5707
E-Mail: aandrews@lrlaw.com

Newsletter

Life, Health and Disability News

 2009 Life Health and Disability News - Spring.pdf
html version  |  archives  |  rss 

Newsletter

html version  |  archives  |  rss 

Seminar

Life, Health, Disability and ERISA Claims

Wednesday, April 28, 2010
Swissotel
Chicago, IL

© Copyright 2010 DRI   |   FAQs   |   Sitemap