ERISA Discretionary Clauses

Discretionary Clauses in Employee Retirement Income Security Act (ERISA) policies — In protecting deference in the face of substantial claims procedure violations, the United States 5th Circuit’s position not only conflict with other United States Circuits but with the Texas Department of Insurance and other state insurance commissioners regarding what is fair to an insured.  In the balance between an individual insured’s rights and the efficiency of the federal court system, the 5th Circuit has found the latter to be more important, perceiving de novo review to be a threat to the court’s efficiency.  The Texas Department of Insurance and Texas legislators perceive deference to be a greater threat. In 2010, the Texas Commissioner of Insurance wrote as follows regarding discretionary clauses in policies that are meant to bind a court to deferential standard of review: “Discretionary clauses are unjust, encourage misrepresentation, and are…

Read more detail on Recent Insurance Law posts –

Related news:

  • Illinois Law Prohibits Discretionary Clauses in Insurance Contracts If you’ve had a legitimate insurance claim denied in Illinois — whether a health insurance claim or a disability insurance claim — then you may find that the insurer justifies their denial […]
  • ERISA – Will It Change? Lawyers who handle Employee Retirement Income Security Act (ERISA) claims will tell that insurance claims made on an individual policy and claims made on an ERISA plan are remarkably […]
  • The Futility Exception to the ERISA Requirement that Claimants Must Exhaust Their Administrative Remedies in Order to be Able to File a Lawsuit If you have an ERISA long-term disability claim, you cannot file a lawsuit challenging an insurer’s denial of benefits until you have exhausted your administrative remedies.  So, even if […]
  • ERISA Claim – 5th Circuit After reporting just a few days ago about a significant victory on an ERISA case, today we are reporting on a loss from the 5th Circuit.  This case is from Eastern District of Lousiana but […]
  • ERISA Regulations The Employee Retirement Income Security Act (ERISA) is governed by federal statutes. The claims procedures originate from 29 U.S.C., Section 1133 and 1135.  Section 1133(1) requires that a […]
  • Insurance Policy Anti-Assignment Clauses Most people do not know what an anti-assignment clause in an insurance policy means.  This issue is discussed in a 2018, opinion from the 14th Court of Appeals.  The opinion is styled, […]
  • Life Insurance And ERISA Ruling Here is a case from the United States 7th Circuit that deals with life insurance when the policy is an Employee Retirement Income Security Act (ERISA) policy.  The case is styled, Emma […]
  • ERISA Insurance And Administrative Review Lawyers who handle ERISA cases always have to explain to their clients that in ERISA cases, the administrative process has to be completed before a lawsuit can be filed.  This is […]
  • Employer Health Plan That Is Governed By ERISA The 5th Circuit Court of Appeals issued an opinion on January 31, 2019, in a case that is governed by the ERISA.  The opinion is styled, Karen A. Rittinger v. Healthy Alliance Life […]
  • Life Insurance And Murder – ERISA What happens when the named beneficiary on a life insurance policy intentionally causes the death of the insured?  That was the question in this case from the Western District of Texas, […]
This entry was posted in Insurance and tagged , , . Bookmark the permalink.

Leave a Reply