Published
This month’s Friday Five explores decisions discussing venue and the deference to be afforded a plaintiff’s chosen venue, an award of costs to the insurer where the plaintiff sought to restart the case in a different jurisdiction, whether an employer and claims administrator can change the rationale for denying a claim in litigation, whether a plaintiff provided sufficient evidence via oral testimony as to whether he timely appealed the denial of his benefits, and whether a claims administrator must provide a plaintiff the ability to submit documents when it decides the claim solely on an eligibility determination.
The Saul Ewing ERISA Litigation Team
- Plaintiff’s choice of venue upheld even though no relevant conduct occurred in the chosen venue, the plaintiff resided and some of her doctors were located in another district, and the defendant was located out of state. Plaintiff commenced litigation challenging the denial of an LTD claim stemming from long COVID. Plaintiff alleged that the defendant insurer improperly denied her claim when it knew or should have known that she was disabled, and that the insurer failed to provide a reasonable explanation for the denial of benefits, failed to provide an adequate description of how Plaintiff could perfect her claims, and failed to properly investigate the merits of her claims. The insurer moved to transfer the case from the Northern District of California to the Eastern District of California because Plaintiff lived in the Eastern District, her doctors were primarily located in the Eastern District, no relevant conduct occurred in the Northern District, no one who administered Plaintiff’s claim was located in the Northern District, and the insurer is a Maine citizen. The court held that, while venue was proper under ERISA’s broad venue provisions, the factors courts consider in determining whether venue should be transferred weighed against transfer. In particular, the court held that: the Plaintiff’s chosen forum favored denying transfer, although this presumption was less weighty because Plaintiff did not reside in the chosen forum; while there were connections in both forums, Plaintiff primarily worked in the Northern District and some of her doctors with relevant opinions as to her disability claim were located in the Northern District; even though Plaintiff was seeking a faster paced docket in the Northern District, this was not improper forum shopping prohibited by the Ninth Circuit; the convenience of the parties was neutral because no party resided in the Northern District and the fact that Plaintiff’s counsel was located in the Northern District was not relevant under the statute; the convenience of witnesses slightly favored transfer because most of Plaintiff’s doctors were in the Eastern District; access to evidence was neutral because the case likely would be resolved on the administrative record; both forums were equally familiar with applicable law; the local interest of both Districts was neutral; there was no showing that the case should be consolidated with another matter; and court congestion weighed against transfer since the Northern District had a shorter median time to resolve cases. Ultimately, the court decided not to transfer the case because Plaintiff’s choice to bring her case in the Northern District was entitled to deference, especially in an ERISA case. Kelsey Goldman v. Unum Life Ins. Co., 3:26-cv-1022, 2026 WL 2184768 (N. D. Cal. July 21, 2026).
- Insurer’s costs, but not attorney’s fees, awarded for Plaintiff’s effort to dismiss and refile case in new venue after litigating it for seventeen months in a different venue and engaging in inconsistent litigation conduct. Plaintiff asked a magistrate judge to transfer her ERISA case or, in the alternative, dismiss the case without prejudice. Defendants opposed the request. The magistrate judge granted the motion, and sua sponte held that venue was improper in the Southern District of Florida because the complaint failed to plead venue and because the Defendant did not respond to Plaintiff’s request to transfer venue. Defendant objected to the magistrate judge’s report and recommendation, arguing that it sufficiently responded to Plaintiff’s request by indicating it wished the case to be resolved on summary judgment. In the alternative, Defendant objected and asked that if the case was dismissed, Plaintiff should be ordered to pay attorney’s fees if she refiled the case. The district court determined that venue was proper under ERISA in the Southern District of Florida because Defendant, “a nationwide insurer that does business within this District, can be ‘found’ here.” The district court also held that transfer was not proper because Plaintiff chose to file the case in the Southern District of Florida, despite residing in the Southern District of New York, and the case had been pending and actively litigated for over seventeen months. The parties had filed summary judgment motions, showing the case was close to resolution. Ultimately, the court granted Plaintiff’s request to dismiss the case without prejudice so she could refile it, but the Court ordered the Plaintiff to pay all costs (but not fees) incurred by Defendant if the case was refiled. Fees were deemed appropriate because the Plaintiff acted inconsistently throughout the pendency of the case by filing and litigating the case in the Southern District of Florida, seeking to keep the case in the Southern District for months after her prior counsel withdrew, and participating in a settlement conference after first trying to continue it at the last minute, and then requesting that it be discontinued after only an hour. Bennett v. Hartford Life & Accident Ins. Co., No. 25-CV-21039, 2026 WL 2450696 (S.D. Fl. Aug. 21, 2026).
- Motion to dismiss denied where basis for denial of benefits was held to be a post-hoc rationale, it was unclear who as between the employer and the claim administrator made the decision, and claims for failure to provide documents and breach of fiduciary duty were adequately pled. Plaintiff submitted a claim for STD benefits based on Persistent Postural-Perceptual Dizziness (PPPD). The claim was denied because the plaintiff was not an eligible employee on the first day of his disability as defined by the plan. The plaintiff sued, alleging that denial of the claim was an abuse of discretion because the claims administrator failed to conduct a full and fair review of the claim and failed to provide all documents upon which it relied. The defendants, plaintiff’s employer and the claim administrator, moved to dismiss. The court declined to dismiss the STD claim because the defendants relied on a different contract provision than when the claim was denied, which the court found to be an impermissible post-hoc rationale. The court also held it was premature to review whether the eligibility determination was reasonable because it was unclear who controlled the administration of the plaintiff’s claim. The court held that the plaintiff had adequately pled that defendants had failed to timely provide the documents under which the plan operated. The court also held that the complaint plausibly alleged that the claims administrator acted as a fiduciary and that the employer influenced the claims administrator’s decisions on the claim, such that dismissal would be premature. Finally, the court held that, although related to each other, Plaintiff’s equitable relief claim was pleaded under a distinct legal theory and, thus, not duplicative of his ERISA claim. Chinh Huynh v. Schwan’s Shared Svcs., LLC, NO. 25-3988, 2026 WL 2363632, (D. Minn. Aug. 14, 2026).
- Oral testimony from the claimant held insufficient to prove administrative appeal was timely filed and administrative remedies were exhausted. After the plaintiff’s claim for LTD benefits was denied, he contended that he submitted a timely appeal. The defendant, however, asserted that it never received notice of the appeal. In litigation, the defendant sought, and was granted, judgment under Federal Rule of Civil Procedure 52 on the ground that the plaintiff had failed to exhaust his administrative remedies. As a threshold matter, the court held that the plan at issue required exhaustion. The court then examined the evidence, which included the plaintiff’s testimony that he began drafting a letter in March 2021, sent the letter in January 2022, and sent a follow up letter in July 2022. The plaintiff did not, however, provide either hard or electronic copies of these documents. The court did not credit plaintiff’s testimony, finding that the plaintiff likely did not provide copies because metadata would reveal that he did not draft the letters when he said he did. The court also took a negative inference from the fact that even though plaintiff was an attorney and deemed to be a sophisticated party, he failed to utilize priority mail until his last, untimely letter. The court also found the defendant’s evidence regarding the reliability of their mailroom was credible. Finally, the court held that the plaintiff was not entitled to rely on the “mailbox rule” because he had not established that he actually mailed the letters. The district court’s decision has been appealed. James A. Stempel v. Unum Life Ins. Co. of America, No. 24 C 6077, 2026 WL 2241244 (N.D. Ill. Aug. 4, 2026).
- Denial of claim upheld even though claimant was not permitted to provide documents, and review process spanned only eighteen days because denial was based on eligibility, not disability, determination. After the plaintiff’s claim for LTD benefits was denied, he filed suit. The plaintiff asked the court to remand his claim to the defendant for reconsideration because the defendant did not allow the plaintiff a reasonable time to provide documents supporting his appeal and the defendant considered the claim for only eighteen days. The defendant claimed that it rightfully denied the claim because the plaintiff was only out of work forty-nine days and thus did not satisfy the elimination period. The defendant argued that the timing of the review was irrelevant because the claim was denied exclusively on whether the plaintiff was eligible for benefits, not whether he was disabled. The court held that because the decision denying benefits was always based on whether the plaintiff was eligible, not his medical disability, and because he could not have submitted any documents to change that decision, remand was not warranted. Wingfield v. United of Omaha Life Ins. Co., No. 3:25-11648, 2026 WL 2268478 (D.S.C. Aug. 6, 2026).
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