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10-3898 & 11-1006 Weitzenkamp v. UNUM Life Ins. Co. of America
Insurance ERISA; self-reported symptoms limitation The failure to include a self-reported symptoms limitation in the summary plan description (“SPD”) prevents an ERISA plan from relying on it to discontinue benefits. “Here, the SPD clearly sets out that long-term benefits will be discontinued after twenty-four months if a participant’s disability is due to mental illness or […]
10-3917, 10-3918, 10-3988 & 10-3989 Thompson v. Retirement Plan for Employees of S.C. Johnson & Son, Inc.
Employment ERISA; deference
10-2112 Jackman Financial Corp. v. Humana Ins. Co.
Insurance ERISA; facility-of-payment clauses Where a life insurance policy contained a facility-of-payment clause, it did not violate ERISA for the insurer to pay the proceeds to the insured’s children. “Under the arbitrary and capricious standard, we overturn the administrator’s decision only where there is an absence of reasoning to support it. See Hess v. Reg-Ellen […]
09-804 Cigna Corp. v. Amara
ERISA Equity Although ERISA does not give district courts authority to reform a pension plan, relief is authorized by sec. 502(a)(3), which allows a participant, beneficiary, or fiduciary “to obtain other appropriate equitable relief” to redress violations of ERISA “or the [plan’s] terms.” This Court has interpreted §502(a)(3)’s phrase “appropriate equitable relief” as referring t[...]
09-1750 In re: Motorola Securities Litigation
Securities ERISA; affiliated purchasers A corporation’s profit sharing plan cannot claim a share of the settlement of a securities fraud action. “[T]he Plan is an affiliate of Motorola and on this basis is excluded from the class, although we arrive at this conclusion by a slightly different analysis. The district court applied the ordinary meaning […]
09-2326 Edwards v. Briggs & Stratton Retirement Plan
Insurance ERISA Where an ERISA claimant failed to file a timely administrative appeal, the plan is not required to consider the appeal. “In this case, the Plan has fixed a clear deadline of 180 days for filing administrative appeals from denials of benefits, and the Plan has the right to enforce that deadline. Also, though […]
10-1061 & 10-2749 Huss v. IBM Medical & Dental Plan
ERISA Attorney fees Where an insured obtains some success in suing an ERISA plan for denial of benefits, but may not ultimately prevail, the district court’s award of attorney fees is vacated pending reconsideration on remand. “We would be hesitant to conclude that the Defendants’ position, though unsuccessful in significant part, was so indefensible as […]
09-3428, 09-3452, 09-3497, 10-1851, 10-2079 & 10-2091 Peabody v. Davis
ERISA Breach of fiduciary duty; diversification Where a retirement plan failed to diversify despite the investment’s collapse, the plan was properly found liable for breach of fiduciary duty. “We agree with the district court that a prudent investor would not have remained so heavily invested in RIC’s stock as the company’s fortunes declined precipitously over […]
10-1469 George v. Kraft Foods Global, Inc.
ERISA Breach of fiduciary duty Summary judgment was improperly granted to the defendant on a breach of fiduciary duty claim under ERISA, where the 401(k) plan had a unitized structure. “[T]he district court’s grant of summary judgment rests on its finding that the undisputed facts established that defendants actually made a reasoned decision between the […]
09-3865 Smith v. Medical Benefit Administrators Group, Inc.
Employment ERISA; equitable relief Where an ERISA plan authorized surgery and then denied the claim for benefits after the surgery took place, the insured may be entitled to equitable relief. “[S]ection 502(a)(3) does authorize an award of declaratory and injunctive relief. The complaint’s prayer for relief sought both types of relief, R. 1 at 12-13, […]
09-2964 Central States, Southeast & Southwest Areas Pension Fund v. Auffenberg Ford, Inc.
Labor ERISA; modification An oral agreement cannot modify a written agreement, even if written notice is provided. “Auffenberg cites Central States, Southeast & Southwest Areas Pension Fund v. Behnke, Inc., 883 F.2d 454 (6th Cir. 1989), in support of the proposition that CBAs can be orally modified as long as written notice is given. But […]
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