Archive for the ‘Administrative Record’ Category

Under ERISA , Procedural Deficiencies Not Considered When the Standard of Review is De Novo

Litigation pursuant to the Employee Retirement Income Security Act (“ERISA”) is rather unique.  Unlike most cases, ERISA disputes are based on a limited scope of permissible evidence.  The range of that scope is ultimately dependent on which standard of review is employed by the courts.  Typically, when the standard of review is abuse of discretion, […]

Submission of the Claim File: Seal or Redact?

For most insurance litigation, the majority of the evidence used by both sides comes from the claim file, also known as the administrative record in ERISA cases.  The claim file represents the insurance carrier’s written record of its handling and processing of an insurance claim.  Obviously, this information is highly relevant whenever coverage or a […]

Under Abatie, Discovery of Profitability Reports is Not Allowed

Bartholomew v. Unum Life Ins. Co., 579 F.Supp.2d 1339 (W.D.Wash. 2008) Plaintiff, who sued to recover benefits under her long-term disability (LTD) plan, sought to expand the scope of discovery under ERISA by seeking documents outside the Administrative Record. Among others, the Plaintiff requested; “Details of compensation and financial incentives,” “revenue and profitability reports for […]

Hearsay Exception Required for Certain Documents Outside the Administrative Record

Bartholomew v. Unum Life Ins. Co. of America, 588 F. Supp. 2d 1262 (W.D. Wash. 2008.) A Plan participant brought suit under ERISA challenging the claim administrator’s decision to terminate long term disability benefits. On a motion for summary judgment, the District Court held that the hearsay rule barred the court from considering documents that […]

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