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Ninth Circuit Affirms Denial of ERISA Medical Benefits for Residential Mental Health Treatment Under “Medical Necessity” Guidelines.
In R.R.; E. R. v. California Physicians’ Service, d/b/a Blue Shield of California, No. 24-6337, 2026 WL 207507 (9th Cir. Jan. 27, 2026), Plaintiffs-Appellants R.R. and his son E.R. sued…
Northern District of California Applies ERISA Equitable Estoppel to Enforce Longstanding Misrepresentations of Pension Eligibility
In Woo v. Kaiser Found. Health Plan, Inc., No. 23-cv-05063, 2026 WL 194578 (N.D. Cal. Jan. 26, 2026), the Northern District of California granted judgment for a plan participant on…
District Court Denies Summary Judgment in ERISA Benefits Matter Where Hartford Failed to Meaningfully Engage with Evidence Supporting Disability
In Butter v. Hartford Life and Accident Insurance Company, No. 24-11499-MJJ, ---F.Supp.3d----. 2026 WL 172049 (D. Mass. Jan. 22, 2026), the District of Massachusetts denied cross-motions for summary judgment and…
Sixth Circuit Finds Termination of Residential Mental Health Coverage Arbitrary and Capricious Under ERISA but Affirms Dismissal of Parity Act Claim
In T.E. v. Anthem Blue Cross & Blue Shield, No. 25-5407, ---F.4th----, 2026 WL 172050 (6th Cir. Jan. 22, 2026), the Sixth Circuit held that Anthem Blue Cross and Blue…
Texas District Court Recommends Significant ERISA Fee Award, Approves Out-of-District Rates and Rejects Proportionality Arguments
In Dwyer v. UnitedHealthcare Insurance Co., No. 1:17-cv-00439-RP (W.D. Tex. Jan. 21, 2026), on remand from the Fifth Circuit, a magistrate judge in the Western District of Texas issued a…
Ninth Circuit Vacates ERISA Benefit Denials Where Plan Misapplied “Hospital” Definition
In Delgado, et al. v. ILWU-PMA Welfare Plan, No. 24-1845, 2026 WL 161403 (9th Cir. Jan. 21, 2026) (Before: Wardlaw, N.R. Smith, and Miller, Circuit Judges), the Ninth Circuit held…
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