Recent Publications - Norman L. Tolle


Employee Relations Law Journal – From the Courts
March 2, 2018 | Norman L. Tolle | Insurance Coverage | Employment & Labor
Disability Policy Had to Provide Same Benefits for Mental Illness as for Physical Injury, Montana Federal Court Decides The plaintiff in this case worked as a claims adjuster for Farmers Group, Inc. After she became disabled due to her bipolar disorder, she applied for long-term disability benefits under the company’s group disability income plan, issued …
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Employee Benefit Plan Review – From the Courts
January 5, 2018 | Norman L. Tolle | Employment & Labor | Insurance Coverage
Release Did Not Bar Injured Worker from Bringing FMLA Claims Against Former Employer, Third Circuit Rules The plaintiff in this case alleged that he was injured on or about August 12, 2014 while working as an employee of Boscov’s Inc. at a farmers’ market in Reading, Pennsylvania. The plaintiff immediately filed a worker’s compensation claim, …
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Employee Benefit Plan Review – From the Courts
December 7, 2017 | Norman L. Tolle | Employment & Labor | Insurance Coverage
Plaintiffs’ Claimed Violation of California’s “Day of Rest” Law Fails The plaintiffs in this case, former California employees of Nordstrom, Inc., a retail department store, sued the company, alleging that it had violated the provision of the California Labor Code granting employees a right to one “day’s rest” in seven. One of the plaintiffs alleged that, while …
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Employee Benefit Plan Review – From the Courts
October 7, 2017 | Norman L. Tolle | Employment & Labor | Insurance Coverage
California Federal Court Permits Plaintiff in ERISA Suit to Proceed Under a Pseudonym The plaintiff in this case, appearing anonymously as John Doe, filed a lawsuit against Lincoln National Life Insurance Company alleging violations of the Employee Retirement Income Security Act of 1974 (ERISA). Specifically, the plaintiff alleged that, since June 12, 2013, he had been disabled, …
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Employee Benefit Plan Review – From the Courts
September 18, 2017 | Norman L. Tolle | Insurance Coverage
Insurer Could Offset Monthly Disability Payments Against Plaintiff’s Part-Time Earnings, Third Circuit Rules The plaintiff in this case, a gastroenterologist, suffered a debilitating injury to her shoulder and underwent surgery in an attempt to repair the damage. The surgery was only partly successful and the damage from her injury prevented her, for a time, from …
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Employee Relations Law Journal – From the Courts
August 15, 2017 | Norman L. Tolle | Insurance Coverage
Claims Administrator Did Not Wrongly Deny Benefits to Ex-Employee, Seventh Circuit Rules The plaintiff in this case was hired by General Motors as an electrical engineer in 1991. A year later, General Motors circulated a “summary plan description” detailing the disability benefits available to its employees. This document provided that employees who became disabled before accruing …
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Employee Benefit Plan Review – From the Courts
August 15, 2017 | Norman L. Tolle | Insurance Coverage
Agreement That Settled Arbitrations Also Barred Former Employee’s ERISA Action, Ninth Circuit Says In December 2010, the plaintiff in this case, a physician, filed wrongful termination lawsuits against Kaiser Foundation Hospitals (Kaiser) and The Permanente Medical Group, Inc. (TPMG). Both of those lawsuits were consolidated in arbitration. The plaintiff, Kaiser, and TPMG settled those arbitrations in …
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Employee Benefit Plan Review – From the Courts
May 9, 2017 | Employment & Labor | Insurance Coverage
Employee Who Left Job Due to Terminal Illness Was Entitled to Severance Pay, Ninth Circuit Rules The wife of the plaintiff in this case was employed by the American Society for Technion-Israel Institute of Technology (ATS) until her terminal illness forced her to leave her job. The plaintiff contended that his wife was entitled to severance …
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Employee Benefit Plan Review – From the Courts
March 30, 2017 | Employment & Labor | Insurance Coverage
Failure to Timely File ‘Charge’ with EEOC Doomed Plaintiff’s ADA Suit, Seventh Circuit Rules The plaintiff in this case, a senior customer service representative of Christian Brothers Services (CBS), was in an automobile accident in March 2011 as a result of which she had to use a cane and limped. According to the plaintiff, CBS fired …
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Employee Relations Law Journal – From the Courts
March 15, 2017 | Norman L. Tolle | Insurance Coverage
Tenth Circuit Upholds Pension Trust’s Decision to Honor IRS Levies When the plaintiffs in this case retired, they began receiving monthly benefits from the Boilermaker-Blacksmith National Pension Trust, a pension plan in which they participated. However, after the trust received notices of levy for both of them from the Internal Revenue Service (IRS), the trust …
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Employee Benefit Plan Review – From the Courts
February 22, 2017 | Employment & Labor | Insurance Coverage
Seventh Circuit, Joining Other Circuits, Rejects ERISA Plan’s “Coordination of Benefits” Lawsuit Against Health Insurers The plaintiff in this lawsuit, filed in a federal district court in Illinois, was the trustee of the Central States, Southeast and Southwest Areas Health and Welfare Fund, a self-funded plan under the Employee Retirement Income Security Act of 1974 …
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Employee Benefit Plan Review – From the Courts
January 21, 2017 | Employment & Labor | Insurance Coverage
Florida Court Upholds Denial of Long-Term Disability Benefits to Employee Who Worked Fewer Hours  The plaintiff in this case was a financial sales professional with AXA Equitable Insurance Company who said that he experienced neck and back pains stemming from motor vehicle and snowboarding injuries that he had suffered in 2003. The plaintiff regularly worked 70 to …
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Employee Benefit Plan Review – From the Courts
December 21, 2016 | Employment & Labor | Insurance Coverage
Implied-in-Fact CBA Excluded Time Spent Donning and Doffing Work Clothing from Compensable Time, Eighth Circuit Decides Since at least 1967, hourly employees working at the battery manufacturing facility in Joplin, Missouri, operated by EaglePicher Technologies, LLC, were represented by a union, presently known as the United Steel, Paper and Forestry, Rubber, Manufacturing, Energy, Allied Industrial …
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Employee Benefit Plan Review – From the Courts
November 21, 2016 | Employment & Labor | Insurance Coverage
Company’s COBRA Breach Justified Award of Premiums to Former Employee, Eighth Circuit Rules When Health Resources of Arkansas, Inc. (HRA) reduced its work force in response to financial difficulties in 2012, the plaintiff in this case was 57 years old and had been working for HRA since 1987. She had worked her way up from …
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Employee Benefit Plan Review – From the Courts – October 2016
October 17, 2016 | Employment & Labor | Insurance Coverage
Video Surveillance Properly Led Claim Administrator to Terminate Long-Term Disability Benefits, Eleventh Circuit Rules The plaintiff in this case worked for JPMorgan Chase Bank as a technical operations lead – a sedentary position that required sitting most of the day – and had long-term disability insurance coverage as a participant in an employee welfare benefit plan …
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Employee Benefit Plan Review – From the Courts – September 2016
September 6, 2016 | Employment & Labor | Insurance Coverage
Court Permits Plaintiff to Proceed Under a Pseudonym with Complaint Seeking Long-Term Disability Benefits The plaintiff in this case, who alleged that she suffered from HIV/AIDS, brought a lawsuit under the Employee Retirement Income Security Act (ERISA) to recover benefits she asserted were due to her under a long-term disability insurance benefit plan sponsored by her former …
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Employee Benefit Plan Review – From the Courts – August 2016
August 23, 2016 | Employment & Labor | Insurance Coverage
Tribal Government’s ERISA Claims Against Blue Cross May Proceed, Court Rules The Little River Band of Ottawa Indians, a federally recognized Indian tribe, entered into an administrative services contract (ASC) with Blue Cross & Blue Shield of Michigan that provided that the Little River Band was a “self-funded” customer of Blue Cross. As provided in …
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Employee Benefit Plan Review – From the Courts – July 2016
July 1, 2016 | Insurance Coverage
Court Upholds Administrator’s Ruling That New Plan Did Not Include Claimed Benefit The plaintiff in this case was hired as an electrical engineer for Delco Electronics, a division of General Motors (GM), in 1991. The plaintiff was enrolled in an insurance plan covered by GM (the 1992 GM Plan) and was made aware of the …
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Employee Benefit Plan Review – From the Courts – June 2016
June 22, 2016 | Employment & Labor | Insurance Coverage
Relying on Dudenhoeffer, Court Dismisses Action Against ERISA Fiduciary Based on Publicly Available Information The plaintiff in this case was a former employee of J.C. Penney Corporation, Inc., a retail department store, who purchased and held J.C. Penney common stock in her retirement account through the J.C. Penney Savings Profit-Sharing and Stock Ownership Plan. The …
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Employee Benefit Plan Review – From the Courts – May 2016
May 1, 2016 | Insurance Coverage
U.S. Supreme Court Holds That ERISA Pre-empts Vermont Law Requiring Health Plan Disclosures The U.S. Supreme Court has ruled that a Vermont law that required disclosure to a Vermont state agency of payments relating to health care claims and other information relating to health care services was pre-empted by the Employee Retirement Income Security Act …
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Employee Benefit Plan Review – From the Courts – April 2016
April 1, 2016 | Insurance Coverage
U.S. Supreme Court Rules that ERISA Fiduciary May Not Seek Reimbursement from Plan Participant’s General Assets Robert Montanile was a participant in a health benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA) and administered by the board of trustees of the National Elevator Industry Health Benefit Plan. The plan provided …
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Employee Benefit Plan Review – From the Courts – March 2016
March 1, 2016 | Insurance Coverage
Fourth Circuit Rules that Employee Handbook’s Arbitration Provision Was Unenforceable The plaintiff in this case began working for Prime Communications, L.P., an authorized retailer of AT&T wireless communication devices and services, in October 2009 as a “solutions specialist” in a retail store in Fuquay-Varina, North Carolina. As a solutions specialist, the plaintiff sold merchandise and cell-phone …
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Employee Benefit Plan Review – From the Courts – February 2016
February 1, 2016 | Insurance Coverage
Long-Term Disability Benefits May Be Reduced by Amount of Worker’s Compensation Lump Sum Disability Award The plaintiff, an employee of The Lubrizol Corporation, sustained a disabling injury at work in July 2011. He filed for long-term disability benefits under The Lubrizol Corporation Long-Term Disability Plan in December 2011. His claim was approved in January 2012, and …
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Employee Benefit Plan Review – From the Courts – January 2016
January 1, 2016 | Appeals | Insurance Coverage
Plaintiff’s Failure to Show Employer Knew She Was Working Overtime Without Pay Dooms Her FLSA Claim The plaintiff in this case was employed as a personal trainer and group fitness instructor at Equinox South Beach, a health and fitness club in Miami Beach, Florida. The plaintiff claimed that Equinox had violated the federal Fair Labor …
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From the Courts
December 1, 2015 | Insurance Coverage
Sixth Circuit Rules that SPD’s Subrogation Provision Was Enforceable, Even in Absence of a Separate Written Plan A beneficiary of the health benefits plan established under the Employee Retirement Income Security Act of 1974 (ERISA) by a trust agreement entered into by participating elevator companies and the Board of Trustees of the National Elevator Industry …
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From the Courts
November 1, 2015 | Insurance Coverage
Private Settlements of FLSA Claims Require Court or DOL Approval, Second Circuit Rules The plaintiff in this case worked at both Freeport Pancake House, Inc., and W.P.S. Industries, Inc. (together, Freeport Pancake House) as a restaurant server and manager over the course of several years. In August 2012, the plaintiff sued Freeport Pancake House, seeking to …
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From the Courts
October 1, 2015 | Appeals | Insurance Coverage
Divorced Wife Was Not an “Eligible Spouse” Entitled to Survivor Benefits under Ex-Husband’s Pension Plan, Eleventh Circuit Rules The plaintiff’s husband was a participant in the El Paso Corporation Pension Plan, under which he received retirement benefits beginning in 1987. The plaintiff and her husband divorced in 2011, and he died about eight months later. After …
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From the Courts
September 1, 2015 | Appeals | Insurance Coverage
Oral Complaints to Employer Alleging FLSA Violations Could Serve as Basis for Retaliation Claim, Court Rules For more than 15 years, the plaintiff in this case worked as a truck driver for William C. Wernicki Trucking Co., a Connecticut company owned by Ena Wernicki that provides mail-hauling services pursuant to several contracts with the U.S. …
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From the Courts
August 1, 2015 | Appeals | Insurance Coverage
U.S. Supreme Court Says that Fiduciary’s Duty of Prudence Involved Continuing Obligation to Monitor Investments and Remove Imprudent Ones In 2007, several individual beneficiaries of the Edison International 401(k) Savings Plan, a defined-contribution plan, filed a lawsuit on behalf of the plan and all similarly situated beneficiaries against Edison International and others. The plaintiffs sought to …
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From the Courts
July 1, 2015 | Appeals | Insurance Coverage
Court Dismisses Wage-and-Hour Claims against Wal-Mart The plaintiff in this putative class action alleged that, during the time she had been employed by Wal-Mart Stores, Inc., as a pharmacist, she took the home study and test portions of the APHA Immunization Certification Training Course. The plaintiff contended that the training course was “directly related” to …
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From the Courts
June 1, 2015 | Appeals | Insurance Coverage
Court Limits Prejudgment Interest on Plaintiff’s Award to Federal Interest Rate A jury reached a verdict in favor of the plaintiff in this case and against Pfizer, Inc., on her claims of discrimination and retaliation based on her disability under Title I of the Americans with Disabilities Act (ADA) and the Oregon Rehabilitation Act. The jury awarded …
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From the Courts
May 1, 2015 | Appeals | Insurance Coverage
Plaintiff’s Statements to Social Security Administration Doom His ADA Discrimination Claim, Tenth Circuit Rules After the plaintiff in this case allegedly suffered a workplace injury, he sought and obtained Social Security disability benefits on the ground that he was unable to work. While the plaintiff was representing to the Social Security Administration that he was …
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From the Courts
April 1, 2015 | Appeals | Employment & Labor | Insurance Coverage
U.S. Supreme Court Reverses Decision Finding that Collective Bargaining Agreements Created Right to Lifetime Contribution-Free Health Care Benefits The plaintiffs in this case had worked at, and in 1996 and 1998 had retired from, the Point Pleasant Polyester Plant in Apple Grove, West Virginia. During their employment, the plaintiffs were represented in collective bargaining by …
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From the Courts
March 1, 2015 | Appeals | Insurance Coverage
U.S. Supreme Court Rules that Time Spent to Undergo Antitheft Security Screening is Not Compensable under the FLSA Integrity Staffing Solutions, Inc., a company that provides warehouse staffing to Amazon.com throughout the United States, required its employees to undergo a security screening before leaving the warehouse at the end of each day. During this screening, …
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From the Courts
February 1, 2015 | Appeals | Insurance Coverage
Plan Administrator Did Not Err In Requiring Plaintiff to Provide Objective Evidence of Her Fibromyalgia The plaintiff in this case alleged that her health began to deteriorate beginning in early 2009, with symptoms that included debilitating pain and fatigue. By the end of that year, according to the plaintiff, these symptoms forced her to leave her …
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From the Courts
January 1, 2015 | Insurance Coverage
“Equitable Lien by Agreement” Permits ERISA Plan to Recover Third Party’s Payment to Plan Participant After a participant in the National Elevator Industry Health Benefit Plan, a self-funded, multi-employer employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA), was injured in an all-terrain vehicle accident, the plan paid approximately …
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From the Courts
December 1, 2014 | Appeals | Insurance Coverage
Company Is Sanctioned for Failing to Issue a Timely “Litigation Hold” in ERISA Cases Foot Locker, Inc., was sued on June 23, 2006 and again on November 30, 2006 with respect to the conversion of its retirement plan from a “defined benefit” pension plan to a “cash balance” plan. The June 23, 2006 complaint alleged …
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From the Courts
October 31, 2014 | Appeals | Insurance Coverage
Circuit Court Upholds Decision Rejecting FMLA Claims Against Employer The plaintiff in this case was employed by BT Americas, Inc., as a consultant for approximately three years. As a consultant, the plaintiff was assigned by BT Americas to work on telecommunications projects with client companies, and she often worked with employees of those companies. The …
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From the Courts
September 30, 2014 | Appeals | Insurance Coverage
Job Applicant Fails in Suit Challenging Company’s Decision to Rescind Conditional Job Offer Based on His Medical Exam The plaintiff in this case applied for a systems engineer position with Southern Nuclear Operating Company at one of its nuclear power plants. Southern Nuclear extended the plaintiff a job offer contingent on satisfactory completion of a …
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From the Courts
August 31, 2014 | Appeals | Insurance Coverage
U.S. Supreme Court Rejects “Presumption of Prudence” for ESOP Fiduciaries The plaintiffs in this case, former employees of Fifth Third Bancorp and participants in its employee stock option plan (ESOP), sued Fifth Third and various Fifth Third officers in a federal district court in Ohio, alleging that they knew or should have known by July …
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Citing Surveillance Videos and Other Evidence, Circuit Court Upholds Plan Administrator’s Decision to End Employee’s Long Term Disability Benefits
July 31, 2014 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case was employed by BDP International as an air import coordinator. Her full time sedentary job required her to sit for most of an eight hour day and, occasionally, to lift or carry a small amount of weight. After she was diagnosed with relapsing-remitting multiple sclerosis (“MS”) in the late 1990s, …
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ADA Accommodation Claim by Janitor Who Alleged She Had a Sensitivity to Cleaning Products Is Rejected
June 30, 2014 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case worked for Knight Facilities Management-GM, Inc., as a janitor for several years, during which time she alleged that she developed a sensitivity to cleaning products. After she went to her family physician with symptoms, the doctor recommended that the plaintiff miss work for a week and wear a mask when …
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Severance Payments Made to Terminated Employees Are Taxable Wages, Supreme Court Rules
May 31, 2014 | Appeals | Employment & Labor | Insurance Coverage
Before and after voluntarily entering bankruptcy, Quality Stores, Inc., an agricultural-specialty retailer, terminated thousands of employees. The employees received severance payments that were the result of a reduction in work force or a discontinuance of a plant or operation pursuant to two different termination plans. Under the first plan, terminated employees received severance pay based …
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Deducting Balances Due on Company-Guaranteed Credit Cards from Employees’ Final Paychecks Did Not Violate FLSA, Circuit Court Rules
April 30, 2014 | Appeals | Employment & Labor | Insurance Coverage
The plaintiffs in this case sued their former employer, Costco Wholesale Corporation, under the federal Fair Labor Standards Act (FLSA) and the California Labor Code, alleging that Costco improperly had withheld wages from their final paychecks to repay the undisputed outstanding balances due on their company-guaranteed credit cards. After a bench trial in which the …
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Anatomy of a Late Claim
March 31, 2014 | Appeals | Insurance Coverage
A recent decision by the U.S. Court of Appeals for the Sixth Circuit, affirming a federal district court ruling, highlights the importance for both employers and employees of the language in a health care plan and summary plan description (SPD), including the limitations periods for commencing litigation. The case involved the health care plan for …
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Director of Insurer’s Retirement Plans Business Unit Found Exempt from FLSA Overtime Rules
February 28, 2014 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case was hired by Standard Insurance as Director of Institutional Sales and Product Manager for The Standard’s 403(b) and 457 retirement products shortly after the company introduced a new product into those markets. The plaintiff’s responsibilities included training staff about 403(b) plans, explaining their differences from 401(k) plans, doing what was …
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Claim for Disability Benefits Filed 9 1/2 Years After Payments Had Ceased Is Dismissed on Statute of Limitations Grounds
January 31, 2014 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case sued Raytheon Company on June 13, 2013 for breach of contract because it had discontinued paying long term disability benefits to him in November 2000. The plaintiff, who had been terminated by Raytheon in July 2002, sought $3.8 million in damages. Raytheon moved to dismiss, arguing that the plaintiff’s action …
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From the Courts
January 1, 2014 | Appeals | Insurance Coverage
“Equitable Lien by Agreement” Permits ERISA Plan to Recover Third Party’s Payment to Plan Participant After a participant in the National Elevator Industry Health Benefit Plan, a self-funded, multi-employer employee welfare benefit plan governed by the Employee Retirement Income Security Act of 1974 (ERISA), was injured in an all-terrain vehicle accident, the plan paid approximately …
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CVS Pharmacist Found Exempt from FLSA’s Overtime Rules
December 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case was employed as a pharmacist by CVS RX Services, Inc. His base weekly salary, which was calculated on a 44 hour work week, exceeded $1,250. CVS guaranteed his base salary and classified him as a salaried employee exempt from the time-and-a-half overtime requirements of the federal Fair Labor Standards Act …
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Circuit Court Rejects FMLA Interference Claim Against Secondary Employer
November 30, 2013 | Appeals | Insurance Coverage
Keppel Amfels L.L.C., which builds and repairs offshore drilling platforms and marine vessels at the Port of Brownsville, Texas, relies on lease-labor and temporary staffing agencies, including Perma-Temp Personnel Services, Inc., to staff about half of its local work assignments. Although these agencies fill “temporary” positions, some placements last for several years. Keppel Amfels and …
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Employment Agreement’s Requirement that Employee Bring Legal Actions Within Six Months Is Ruled Invalid with Respect to FLSA and Equal Pay Act Claims
October 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case worked for FedEx Customer Information Services, Inc., under an employment agreement that provided, in part, that “[t]o the extent the law allows an employee to bring legal action against Federal Express Corporation, I agree to bring that complaint within the time prescribed by law or 6 months from the date …
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Court Rules Same-Sex Spouse Entitled to Survivor Annuity under ERISA Profit Sharing Plan
September 30, 2013 | Appeals | Employment & Labor | Insurance Coverage
After Sarah Ellyn Farley began working at a law firm in 2004, she became a participant in the firm’s profit sharing plan.  In 2006, Farley married Jean Tobits in Toronto, Canada, as authorized under Canadian law. Shortly after her wedding, however, Farley was diagnosed with cancer and died in 2010. The profit sharing plan required that, …
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Court Dismisses Breach of Fiduciary Duty Claim against Disability Plan Administrator for Failing to Provide Plan Summary
August 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
After her claim for benefits was denied, the plaintiff in this case, a former employee of Corning Incorporated and a participant in the Corning Incorporated Long Term Disability Plan, sued the plan administrator – the Corning Benefits Committee – for breach of fiduciary duty by virtue of its alleged failure to furnish her with a …
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Circuit Upholds Sanctions against Plaintiff’s Attorney in Case Involving Alleged Breach of Disability Insurance Policy
July 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case sued Paul Revere Life Insurance Co., alleging that Paul Revere had engaged in bad faith and that Paul Revere had breached his disability insurance policy by terminating his disability benefits. The district court dismissed the plaintiff’s bad faith claim, and denied the plaintiff’s two motions for reconsideration. Shortly before trial …
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Court Dismisses Complaint Seeking Payment for MUA Procedures
June 30, 2013 | Appeals | Insurance Coverage
Montvale Surgical Center, LLC, an outpatient ambulatory surgery center, performed three “medically necessary” spinal manipulation under anesthesia (MUA) procedures on New Jersey resident Gerald Tyska at its facility. Tyska subscribed to a fully-funded group health insurance plan maintained by Coventry Health Care, Inc., and assigned his rights under the plan to Montvale. Montvale submitted requests …
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U.S. Supreme Court Rules that Offer of Judgment that Mooted Plaintiff’s FLSA Case Required that It Be Dismissed
May 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
In 2009, Laura Symczyk, who had been employed by Genesis Healthcare Corporation as a registered nurse at its Pennypack Center in Philadelphia, Pennsylvania, filed a complaint on behalf of herself and “all other persons similarly situated” – known as a “collective action” – that alleged that Genesis had violated the federal Fair Labor Standards Act …
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Circuit Upholds Decision Denying Disability Benefits for Employee Who Claimed She Had Fibromyalgia
April 30, 2013 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case worked for American International Group (AIG) and participated in its group long term disability benefit plan, which was governed by the provisions of the Employee Retirement Income Security Act (ERISA) and administered by Hartford Life and Accident Insurance Company. After several hospitalizations, the plaintiff filed a claim for long term …
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Handbook’s Disclaimer Insufficient to Bar State Wage Claim
March 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
The plaintiffs in this case brought a class action in federal court against Comcast Corporation and Comcast Cable Communications Management, LLC, alleging among other things that the defendants had violated the Illinois Wage Payment and Collection Act (IWPCA) which requires every employer “at least semi-monthly, to pay every employee all wages earned during the semi-monthly pay …
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Facebook Photos Doom Employee’s FMLA Retaliation Claim
February 28, 2013 | Appeals | Employment & Labor | Insurance Coverage
After working for Advantage Health Physician Network for about 18 months, the plaintiff in this case began taking intermittent leave under the Family and Medical Leave Act, claiming that she was incapacitated from pain from a back injury she had sustained years earlier. About five weeks into her leave, several of her coworkers saw pictures …
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LTD Plan Administrator Need Not Consider Social Security Administration Decided After Its Final Decision
January 31, 2013 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case, who worked for GKN North America Services until January 2009 when she stopped due to persistent pain from various medical conditions, filed a claim for disability benefits under an insurance policy issued by Hartford Life and Accident Insurance Company. The plaintiff received short term disability benefits through July 21, 2009, …
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Employer Does Not Violate FLSA by Changing Workweek So Employees Earn Fewer Hours of Overtime
December 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
Five current and former employees of Redland Energy Services, LLC, who worked as operators of Redland’s two drilling rigs, sued Redland, alleging that it had violated an overtime provision of the federal Fair Labor Standards Act (FLSA) by changing the designation of their workweek, but not their work schedule, so that fewer hours qualified as …
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Employee Wellness Program Did Not Violate ADA, Circuit Court Decides
November 30, 2012 | Appeals | Employment & Labor | Insurance Coverage
Several years ago, employees of Broward County, Florida, who enrolled in the county’s group health plan became eligible to participate in a new employee wellness program sponsored by Broward’s group health insurer, Coventry Healthcare. The employee wellness program consisted of two components: a biometric screening, which entailed a finger stick for glucose and cholesterol, and …
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Circuit Court Rejects Claim for Lifetime Health Care Benefits
October 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
Former employees of Xerox Corporation who participated in the Xerox Retiree Flex Health Care Plan alleged in a lawsuit they filed that they repeatedly had been promised lifetime benefits under a health care plan called the Flex Plan but that the defendants had reneged on that promise. The district court dismissed the claims and the …
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Court Refuses to Conditionally Certify FLSA Action as a Collective Action
September 30, 2012 | Appeals | Employment & Labor | Insurance Coverage
The plaintiffs, former customer service representatives (CSRs) who staffed telephone lines at an Appletree Answering Service call center in St. Louis, Missouri, sued Appletree for allegedly violating the Fair Labor Standards Act (FLSA) by failing to pay them for actual hours worked and corresponding overtime. The plaintiffs alleged that Appletree had a nationwide policy of …
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Court Enforces Long Term Disability Policy’s Three Year Statute of Limitations
August 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case held a research position at Cornell University’s Weill Medical College (WMC) since at least 1997. On September 26, 2001, the plaintiff received a termination letter, effective as of September 28, 2001. On March 26, 2002, the plaintiff submitted a claim for disability benefits under WMC’s group long term disability insurance …
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Denial of Employee’s Post-Bankruptcy Disability Claim Bars Recoupment of Pre-Bankruptcy Overpayment of Disability Benefits
July 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case worked as an engineer for the Boeing Company. Under Boeing’s long term disability plan, employees who were totally disabled as a result of accidental injury or illness were eligible for long term disability benefits. During the first 24 months of disability, the plan’s “own occupation” definition of disability applied, under …
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Employee’s Total Weekly Workers’ Compensation Payment May Not Exceed Statutory Cap, Court Rules
June 30, 2012 | Appeals | Employment & Labor | Insurance Coverage
The worker’s compensation claimant in this case worked as a collision shop technician in New York, repairing automobiles. In 2005, he suffered three injuries on the job. On February 21, he slipped on ice, injuring his hip and back. On March 18, he suffered a lower back sprain. He left his job on June 27 …
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Children’s Social Security Disability Benefits Paid For A Parent’s Disability May Reduce Benefits Under Employer Plan, Circuit Finds
May 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
The plaintiffs in this case sued to recover benefits under the long term disability benefit plans that were maintained by their former employers, Aviall, Inc., and Perkins Coie, respectively, and that were issued by the Prudential Insurance Company of America. The plans provided for a reduction of disability benefits if a disabled employee also received …
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Employee Fired While Incarcerated Not Entitled To Unemployment Benefits
April 30, 2012 | Appeals | Employment & Labor | Insurance Coverage
Crystal Mandall started working as a dental assistant for a New Jersey dental center in November 2007. On April 20, 2010, she was arrested on criminal charges. She kept in touch with the dental center through a relative, promising to return to work as soon as she was released. She remained incarcerated until May 1. …
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FMLA Protects Pre-Eligibility Request for Post-Eligibility Leave, Circuit Finds
March 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
The plaintiff in this case began working at a senior living facility operated by Brookdale Senior Living Communities, Inc., in Pompano Beach, Florida, on October 5, 2008. She was terminated 11 months later, in September of 2009. In June 2009, the plaintiff advised Brookdale that she was pregnant and would be requesting leave under the …
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Circuit Court Reverses Dismissal of Complaint Seeking Long Term Disability Benefits On Limitations Grounds
February 29, 2012 | Appeals | Employment & Labor | Insurance Coverage
After the plaintiff in this case brought suit to challenge a denial of long term disability benefits, the district court concluded that the complaint was time-barred by a limitation-of-actions clause in the plan. The plaintiff appealed. The plan, issued by Hartford Life and Accident Insurance Company, generally prohibited a claimant from bringing a lawsuit more …
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“Mailbox Rule” Does Not Help Plaintiff Prove She Mailed Appeal Of Claim Denial
January 31, 2012 | Appeals | Employment & Labor | Insurance Coverage
Under the common law “mailbox rule,” the proper and timely mailing of a document raises a rebuttable presumption that the document was received by the addressee. A recent decision by the U.S. Court of Appeals for the Sixth Circuit in a case involving a claim for short term disability benefits makes it clear, however, that …
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Court Dismisses LTD Claim For Failure To Exhaust Administrative Remedies
December 31, 2011 | Appeals | Employment & Labor | Insurance Coverage
As a full time employee of Toyota Motor Manufacturing North America, Inc., the plaintiff in this case qualified for and participated in Toyota’s short term disability (STD) and long term disability (LTD) plans. The plaintiff contended in his lawsuit that he met the definition of “disability” under both plans but that he had been wrongfully …
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Plaintiff Who Took Part-Time Job Loses Long Term Disability Benefits
November 30, 2011 | Appeals | Insurance Coverage
The plaintiff in this case worked as a Sales Support Assistant for National City Corporation and participated in the National City Corporation Welfare Benefits Plan, which was administered by the Liberty Mutual Group. Under the terms of the plan, a participant was eligible for long term disability benefits when he or she became injured or …
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Pre-Existing Condition Exclusion Bars Employee’s Claim For Long Term Disability Benefits
September 30, 2011 | Appeals | Insurance Coverage
The plaintiff in this case, a chiropractor, worked for Alcott Staff Leasing, Inc., as a medical peer reviewer. In August 2006, she stopped working for Alcott and applied for long term disability benefits; her request was denied based on a pre-existing condition exclusion in the policy, which defined a pre-existing condition as a sickness or …
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Court Dismisses Suit By Employee Discharged Upon His Return From Jury Service
August 31, 2011 | Appeals | Insurance Coverage
Beth Abraham Health Services, a non-profit organization located in the Bronx that provides residential and community-based health care services for adults, hired the plaintiff in this case in October 1997 as an Authorization Specialist. The plaintiff’s main duty was to input information obtained from doctors, nurses, and others into a single, electronically-stored document called a …
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EEOC Entitled To Broad Range Of Information From Company It Is Investigating
July 31, 2011 | Appeals | Insurance Coverage
After Konica Minolta Business Solutions fired an African-American salesman who had been working at the Konica facility in Tinley Park, near Chicago, the salesman filed a charge of discrimination with the Equal Opportunity Employment Commission (EEOC) that stated: Since the beginning of my employment, my Branch Manager has subjected me to different terms and conditions …
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New Jersey Company’s Workers’ Compensation Carrier Is Not Responsible For Claim Stemming From Temporary New York Project
June 30, 2011 | Appeals | Insurance Coverage
An individual who lived in New York claimed that he was injured while working in New York on a project lasting five or six days for his employer, a New Jersey corporation with its sole office in New Jersey. The individual filed a claim in New York for workers’ compensation benefits. Travelers Indemnity Company, the …
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Workers’ Compensation Retaliation Claim Filed More Than Six Months After Employee Was Terminated Is Barred by Contractual Limitation Provision
May 31, 2011 | Appeals | Insurance Coverage
The plaintiff in this case applied for a position with the Federal Express Corporation in November 1993, completing and signing an employment application and employment agreement. One of the provisions of the employment agreement provided that “to the extent law allows an employee to bring legal action against Federal Express, I agree to bring that …
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Foreign Workers May Proceed With FLSA Claims Seeking Reimbursement For Their Recruitment, Visa And Transportation Expenses, Court Rules
April 30, 2011 | Appeals | Insurance Coverage
Between 2004 and 2009, Trugreen Landcare LLC, which provides lawn and landscape services in the United States to approximately two million customers, obtained permission from the United States government to hire temporary foreign workers pursuant to the federal H-2B visa program. The plaintiffs in this case were individuals who resided outside of the United States …
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Court Rejects FMLA Claim By Employee Who Tested Positive For Alcohol
March 31, 2011 | Appeals | Insurance Coverage
When the plaintiff in this case was first hired by Home Depot in November 2001, she received a copy of Home Depot’s Code of Conduct, which listed “Major Work Rule Violations” that could lead to termination. One of these violations was having detectable levels of alcohol as determined by a blood alcohol test. The plaintiff …
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Stranger-Originated Life Insurance and Life Settlements After ‘Kramer’
March 24, 2011 | Appeals | Insurance Coverage
When the New York Court of Appeals issued its decision late last year in Kramer v. Phoenix Life Ins. Co.,[1] holding that New York law permitted a person to procure an insurance policy on his or her own life and immediately transfer it to one without an insurable interest in that life, even where the …
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Employer’s Claims Against Ex-Employee May Not Be Set-Off Against Her FLSA Claims Against Employer
February 28, 2011 | Insurance Coverage
When the plaintiff in this case was laid off from her job at PepsiAmericas, Inc. (Pepsi), she entered into a severance agreement under which she agreed not to file “any complaints, charges, lawsuits, or any other claims against the Company arising out of the employment relationship and/or termination of employment.” In return, Pepsi agreed to …
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Actress Hurt While Bicycling Is Entitled To Workers’ Compensation Benefits
January 31, 2011 | Insurance Coverage
The plaintiff in this case was hired by the Gateway Playhouse in the Long Island village of Bellport to perform in two musicals during the summer of 2008. During that time, she lived in free housing provided by Gateway on its premises. On the morning of July 15, 2008, as was her practice throughout the …
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Airport Shuttle Driver’s Overtime Claim Fails On Motor Carrier Exemption
December 31, 2010 | Insurance Coverage
The plaintiff in this case was a former driver of Southern Shuttle Services, Inc.’s airport shuttle vans, a shared-ride airport shuttle, which transported passengers to and from three South Florida airports (Miami International Airport, Palm Beach International Airport, and Fort Lauderdale-Hollywood International Airport). The plaintiff, like other shuttle drivers, was paid commission and tips, but …
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Renal Cancer In Remission Found To Be A Disability Under The ADA
November 30, 2010 | Appeals | Insurance Coverage
The plaintiff argued that his employer, Advanced Healthcare, had violated the Americans with Disabilities Act (ADA) when it allegedly terminated him on January 30, 2009. The plaintiff claimed he was a qualified individual with a disability under the ADA because his renal cell carcinoma (which was in remission at the time of the alleged termination) …
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Five Factors Govern Attorney’s Fees Awards To Party Who Had “Some Degree of Success On the Merits,” Ninth Circuit Says
October 31, 2010 | Appeals | Insurance Coverage
Section 1132(g)(1) of ERISA states that in an action under ERISA, such as one by an employee to obtain benefits pursuant to an employer’s disability income insurance plan, the court, in its discretion, may allow reasonable attorney’s fees and costs of action to either party. This past May, in Hardt v. Reliance Standard Life Ins. …
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Written Request To Change Life Insurance Beneficiary Found Effective
September 30, 2010 | Appeals | Insurance Coverage
Richard Smith was employed by Bonetti Company, Inc., and participated in the group life insurance plan that the company provided. Smith had basic life insurance coverage of $50,000 and supplemental life insurance coverage of $50,000, and he designated Alma, to whom he was married at the time his application for coverage was accepted, as the …
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Circuit Court Agrees Crane Dispatcher Exempt from FLSA Overtime Rules
August 31, 2010 | Insurance Coverage
The plaintiff in this case was employed in several different capacities by Sunbelt Cranes, Construction & Hauling, Inc., from 1999 until 2008. When he resigned, he was a dispatcher in the company’s crane rental division. Thereafter, the plaintiff brought suit against Sunbelt under the Fair Labor Standards Act (FLSA) for unpaid overtime compensation. Sunbelt responded …
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“Some Degree of Success On the Merits” Enough For Claimant
July 31, 2010 | Insurance Coverage
In most lawsuits seeking relief under §1132(g)(1) of ERISA, “a reasonable attorney’s fee and costs” are available “to either party” at the court’s “discretion.” In this case, the U.S. Court of Appeals for the Fourth Circuit interpreted §1132(g)(1) to require that a fee claimant be a “prevailing party” before the claimant may seek a fee …
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Prevailing Plaintiff Denied Attorney’s Fees
June 30, 2010 | Appeals | Insurance Coverage
The plaintiff in this case brought a lawsuit under ERISA against Liberty Life Assurance Company of Boston after the insurer denied her claim for partial disability benefits. After the parties filed motions for summary judgment, the district court remanded the matter to the insurer for further administrative review of her claim. The district court instructed …
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Decision Based on Administrator’s Honest Mistake Entitled to Deference
May 31, 2010 | Insurance Coverage
The plaintiffs in this case were employees of Xerox Corporation who left the company in the 1980s, received lump sum distributions of retirement benefits they had earned up to that point, and later were rehired. To account for the plaintiffs’ past distributions when calculating the present benefits to which they were entitled (i.e., to avoid …
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Employee Loses Religious Discrimination Suit
April 30, 2010 | Appeals | Insurance Coverage
In September 2007, Triumph Apparel Corporation fired the plaintiff after approximately one year of employment after she refused either to accept part-time employment or to remain at work until 3:00 p.m. on Fridays. Asserting that Triumph had refused to accommodate her religious observance of the Jewish Sabbath, the plaintiff sued for employment discrimination on the …
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New Life Settlement Law Protects Policyholders and Regulates Industry
April 22, 2010 | Appeals | Insurance Coverage
Until relatively recently, individuals who had taken out life insurance policies to protect their families in the event they died while their children were young or before they had finished college often would allow those policies to lapse or would surrender them to their insurance companies in exchange for the stated surrender value when they …
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Court Refuses To Dismiss Claim For Additional Compensation
March 31, 2010
In many situations, courts refuse to enforce oral contracts because of state laws known as the “Statute of Frauds.” There are numerous instances, however, where courts will find that the Statute of Frauds does not bar enforcement of an oral agreement. Whether the Statute of Frauds barred an alleged oral agreement was at the heart …
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Court Rejects Claim Over Elimination of Right To Transfer Balance
February 28, 2010 | Appeals | Insurance Coverage
The plaintiff in this case worked for Airborne Express, Inc., which was acquired by DHL Holdings (USA), Inc., now called DPWN Holdings (USA), Inc., in 2003. The plaintiff had been a participant in Airborne’s Retirement Income Plan (RIP) and Profit Sharing Plan (PSP). The RIP was a defined benefit plan whose benefit formula was based …
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Court Rejects Plan Administrator’s Challenge To Employees’ Divorces
January 31, 2010 | Appeals | Insurance Coverage
According to the administrator of the Continental Airlines Pilots Retirement Plan, a group of senior pilots became concerned several years ago about the health of the plan. These pilots already had reached retirement age, but had not retired or been otherwise separated from their employment at Continental. They allegedly engaged in a scheme to obtain …
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