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This month’s Friday Five explores decisions from around the country discussing differences between LTD and LWOP policies, the breadth of discretion available to claims administrators and the always important topic of timely action by insurers in issuing claims decisions. The Saul Ewing Employee...

This month’s Friday Five covers the treatment of job-related stress in assessing an attorney’s disability, the requirements surrounding the qualifications of a medical professional to review a claimant’s medical records in making disability determinations, the requirements for determining disability...

This month’s Friday Five covers cases relating to an alleged conflict of interest leading to discovery, two courts’ opposite treatments of subjective pain complaints, a decision that claims of fraud and misrepresentation were not preempted by ERISA and a court’s deference to an insurer’s...

This month’s Friday Five explores decisions regarding the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, an award of attorneys’ fees, costs, and prejudgment interest, deference to an insurer’s interpretation of a plan’s provisions...

​Last week, the House Ways and Means Committee voted to advance the Tax Relief for American Families and Workers Act of 2024 (H.R. 7024) to the House floor. As drafted, H.R. 7024 would be funded entirely by limitations on the employee retention credit (ERC). Under the bill, no new ERC claims would...

This month’s Friday Five covers cases relating to the enforceability of contractual statute of limitations provisions described as a “labyrinth,” ERISA claims when the carrier allegedly misrepresents benefits, federal courts retaining ERISA jurisdiction following a related state court case, a court...

As we previously have discussed, the IRS has for months been working to combat dubious Employee Retention Credit (ERC) claims, many of which were made at the urging of aggressive promoters. The IRS is offering a limited-time Voluntary Disclosure Program (VDP) to encourage taxpayers to come forward...

This month’s Friday Five explores a decision ordering an IME prior to a ruling on summary judgment motions, the extent claims reporting records can be sealed, the scope of ERISA preemption in the context of removal, and two decisions awarding summary judgment for the defendant despite the plaintiffs...

This month’s Friday Five covers cases relating to petitions for attorneys’ fees, unpersuasive self-reported evidence of disability, and a dilatory attempt to augment the administrative record. The Saul Ewing Employee Benefits/ERISA Litigation Team Western District of Wisconsin Slashes “Eye-Popping”...

On October 19, 2023, the IRS announced a special withdrawal process to help those who filed an Employee Retention Credit (“ERC”) claim and are concerned about its accuracy. This follows the September 14 announcement of a moratorium on processing new ERC claims. The new withdrawal option allows...

This month’s Friday Five explores recent decisions that range from the effect on disability benefits when medical records are not provided after two appeals, to a case that examines how an award of death benefits is determined, to a finding that an insurer’s decision to terminate benefits was not...

​On September 14, 2023, the IRS announced an immediate moratorium on processing new Employee Retention Credit (ERC) claims due to the surge in questionable or potentially fraudulent filings. According to the announcement, the pause will continue through the end of 2023. The IRS will continue to...

This month’s Friday Five explores decisions regarding the timeliness of appeals, the support necessary to sustain an LTD termination decision, a court’s discretion to credit and discredit expert opinions, the circumstances under which an insured may be required to prove they were prejudiced by the...

This month’s Friday Five addresses two cases involving disability claims that touch on Covid-19, a Circuit Court ruling for an insurer, a district court ruling that a 20-year-old regulatory settlement precluded an insurer from relying on the opinions of physicians it hired, and a claim for breach of...

This month’s Friday Five covers cases relating to what constitutes a fiduciary function, a finding of disability despite working full-time, an enforcement of suit limitation clause, the circumstances under which reinstatement is an appropriate remedy, and ERISA preemption. The Saul Ewing LLP...

This month’s Friday Five covers cases relating to a plaintiff’s attempts to seal a complaint seeking disability benefits, an administrator’s uncommunicated decision to discontinue its investigation into certain medical conditions, an administrator’s loss of the deferential standard of review for...

This month’s Friday Five explores two recent decisions that discuss limitations on benefits when both physical disability and disability arising from mental illness are alleged, whether remand of a claim by the court constitutes a new appeal or a continuation of the previous appeal, whether an order...

This month’s Friday Five explores recent decisions that reflect the precise nature of rules and definitions in the context of ERISA claims. For example, effective dates of CFR code provisions and contractually defined limitation periods can draw specific points on the timeline of a case. Similarly...

This month's Friday Five covers cases relating to issue preclusion, coverage where the policy terms are inconsistent with the parties’ behavior, application of the abuse of discretion standard of review, applicability of a waiver of premium provision and compliance with a mandatory appeals process...

​ On February 10, 2023, the Pennsylvania Commonwealth Court issued four separate but related opinions denying property tax exemptions for four hospitals that had been purchased by the Tower Health system. [1] In each case, the court determined that the owner of the hospital did not qualify as an...
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