Order Remanding ERISA Claim to Administrator Was Not Appealable, Because It Did Not Satisfy Collateral Order Test

Dickens v. Aetna Life Ins. Co., 2012 U.S. App. LEXIS 8019 (4th Cir. Apr. 20, 2012) As an employee of Bristol-Meyers Squibb, Dickens participated in the company’s long-term disability plan, under which benefits were funded by a group insurance policy issued by Aetna. Based on diagnoses of depression and anxiety, Dickens applied for LTD benefits

Three-Year Limitation Period, Beginning When Proof of Loss Was Submitted, Bars Action to Recover LTD Benefits under ERISA Plan

Belrose v. Hartford Life & Accident Ins. Co., 2012 U.S. App. LEXIS 7506 (4th Cir. Apr. 13, 2012) Belrose, a full-time employee of Camber Corporation, underwent arthroscopic knee surgery in September 2002. As a participant in his employer’s ERISA plan, Belrose began receiving short-term disability benefits under a group insurance policy issued by Hartford. Shortly

Payment of Life Insurance Premiums with Stolen Money Does Not Authorize Defrauded Party to Recover Benefits

Speedway Motorsports, Inc. v. Pinnacle Bank, 2012 Ga. App. LEXIS 366 (Mar. 29, 2012) In 2004, Speedway hired Oasis Trading Group, of which David Blihovde was a member, to provide consulting services about opportunities in the petroleum products business. Beginning in 2006, Blihovde allegedly sent fraudulent invoices to Speedway and misappropriated the payments. By 2010,

Benefits Not Payable for Disabling Condition That Develops after Final Claim Decision

Lamb v. Hartford Life and Accident Ins. Co., 2012 U.S. Dist. LEXIS 39207 (M.D. Ga. Mar. 22, 2012) Lamb, a truck driver, was insured under a long-term disability plan sponsored by his employer, Wal-Mart. In June 2008, Lamb claimed disability due to a staph infection in his right elbow. Hartford approved the payments of benefits

Court Applying North Carolina Statute in ERISA Case Rules Drunk Driving Death Not “Accidental”

Johnson v. Am. United Life Ins. Co., 2012 U.S. Dist. LEXIS 32718 (M.D.N.C. Mar. 12, 2012) Johnson suffered fatal injuries while driving during the early morning hours when he lost control of his vehicle, traveled off the roadway, struck a highway sign, and overturned several times. The roadway was illuminated by streetlamps and was dry

Denial of Accidental Death Claim Based On Alcohol Exclusion Was De Novo Correct

Smith v. Hartford Life and Accident Ins. Co., No. 1:10-cv-02471 (N.D. Ga. Feb. 17, 2012) Smith was covered by an ERISA-governed accidental death insurance policy provided by his employer. Smith died in a one-car collision, and a toxicology report showed that his blood ethyl alcohol content was 0.206 grams per 100 ml at the time

Action to Recover LTD Benefits Dismissed for Failure to Exhaust Administrative Remedies

Venning v. Metropolitan Life Ins. Co., No. 1:11-CV-0072 (N.D. Ga. Jan. 18, 2012) Venning suffered a head injury that caused chronic headaches, speech impairment, mental disorientation, and deficiencies in concentration. He received short-term disability benefits under an employee welfare benefit plan administered by MetLife. Long-term disability benefits had been paid for one year before MetLife

Death Was Not Due Solely to Accident, Because Prescription Medication Was a Contributing Cause

Slagle v. Life Ins. Co. of N. Am., No. 1:10-cv-0466 (N.D. Ga. Feb. 21, 2012) Slagle was insured by an ERISA-governed accidental death and dismemberment policy, which provided: We agree to pay benefits for loss from bodily injuries: a) caused by an accident which happens while an insured is covered by this policy; and b)

Administrator’s Procedural Errors Allow Claimant To Submit Post-Appeal Supporting Documentation

Cole v. Aetna Life Ins. Co., 2012 U.S. Dist. LEXIS 9007 (D.S.C. Jan. 26, 2012) After working 31 years as a registered nurse at a hospital, Cole submitted a claim for long-term disability benefits under her employer’s welfare benefit plan, which was fully insured by Aetna. She received benefits for disability from her own occupation,

Insurer May Not Retain Premiums When Rescinding Policy, Even if Insurance Was Procured by Fraud

PHL Variable Life Ins. Co. v. Faye Keith Jolly Irrevocable Life Ins. Trust, 2012 U.S. App. LEXIS 5283 (11th Cir. Mar. 14, 2012) PHL Variable Life Insurance Company sued Jolly and the Faye Keith Jolly Trust for negligent misrepresentation of Jolly’s assets in the application for a $10 million life insurance policy. The company sought

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