ERISA and Life Insurance News

Page 1

DECEMBER

2013

ERISA & LIFE INSURANCE NEWS Cover ing ERISA and Life, Health and Disability Insurance Litigation

INSIDE THIS ISSUE Proof “Satisfactory to the Insurer” Held Insufficient to Confer Discretionary Authority

04

Fatal Motorcycle Crash under Influence of Alcohol and Marijuana Not an Accident Under ERISA Plan

05

Methamphetamine Held Not a “Narcotic” Under Exclusion in Life Insurance Policy

06

Court Applies Federal Common Law Presumption Against Death by Suicide

07

Offer of Settlement Did Not Constitute Appeal of ERISA Claims Determination

08

Failure to Identify TPA in the Plan Does Not Defeat Delegation of Discretion

08

No Viable Claim Exists Under § 502(a)(3) Where Relief Is Available Under § 502(a)(1)(B)

09

Substantial Evidence Supported Termination of Disability Benefits, Despite Social Security Award

10

Summary Plan Descriptions and Language of Discretion after CIGNA Corp. v. Amara

In CIGNA Corp. v. Amara, 563 U.S. __, 131 S.Ct. 1866, 1878 (2011), the Supreme Court concluded that summary plan descriptions, “important as they are, provide communication with beneficiaries about the plan, but that their statements do not themselves constitute the terms of the plan for purposes of § 502(a)(1)(B).” Since Amara, the lower courts with relative uniformity have declined to give effect to a grant of discretion found in a summary plan description but absent from the plan document. See, e.g., Ingorvaia v. Reliastar Life Ins. Co., __ F. Supp. 2d __, 2013 WL 2006689, at *2 (S.D. Cal. May 14, 2013) (“where the SPD is not incorporated, or the plan is not otherwise amended to include the SPD’s terms, the SPD’s terms are not binding”); Messer v. Prudential Life Ins. Co. of Am., 2013 WL 1319391, at *8 (W.D.N.C. Mar. 29, 2013) (“the SPD is not part of the Plan and therefore cannot grant discretionary authority to the administrator.”) continued on page 2 >>


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