Many ERISA plans give the claims administrator (often an insurance company) discretionary authority to interpret the evidence and the terms of the employee benefit plan in deciding claims. This discretionary authority makes it difficult for claimants to overturn claim denials because court defer to decisions made using this authority. But ERISA recognizes that claims administrators …
Amy Coney Barrett was recently confirmed to replace Ruth Bader Ginsburg on the U.S. Supreme Court. Justice Ginsburg is remembered as a champion of civil rights and gender justice. But Ginsburg is also responsible for some of the Court's most important ERISA decisions. This invites us to look back on some of Justice Ginsburg's most …
The Ninth Circuit Court of Appeals (the federal appellate court with jurisdiction over Washington and other western states) recently decided a novel question regarding so-called "excess" insurance coverage. Excess insurance exists where a person or entity has two layers of insurance: a "primary" insurer that provides coverage up to a specific dollar amount, and a …
Insurance policies contain technical language that often varies from its everyday meaning. When a case depends on the meaning of the insurance policy fine print, how you interpret these technical terms can decide the outcome of a case. One way to define insurance policy terms is to see how those terms are used elsewhere in …
Continue reading Court Ruling Emphasizes Importance of Reading the Insurance Policy as a Whole
An industry group known as the Insurance Information Institute is analyzing the role racial bias plays in calculating insurance premiums. Explicit racial bias, i.e.., setting premiums directly based on race (known as "redlining") has been illegal since the mid 20th century. But rates continue to bet set based on criteria that indirectly reflect racial bias. …
Continue reading Industry Group Reviewing Insurance Rate Practices for Racial Bias
