Ninth Circuit Reverses Denial of Health Benefits, Finding UnitedHealthcare Abused Its Discretion by Stonewalling Claimant with Cookie-Cutter Denial Letters and Failing to Produce the Claim File for Over Three Years
Ninth Circuit Reverses Denial of Health Benefits, Finding UnitedHealthcare Abused Its Discretion by Stonewalling Claimant with Cookie-Cutter Denial Letters and Failing to Produce the Claim File for Over Three Years
In Campbell v. UnitedHealthcare Insurance Co., No. 24-5736, No. 25-758, 2026 WL 982848 (9th Cir. Apr. 13, 2026), a Ninth Circuit panel composed of Circuit Judges Tallman, VanDyke, and Tung…
Eleventh Circuit Affirms Dismissal of ERISA Benefits Claim for Failure to Plausibly Allege Primary Coverage, but Remands to Permit Amendment
In Mendoza v. Aetna Life Insurance Company, No. 23-13674, 2026 WL 775293 (11th Cir. Mar. 19, 2026), the Eleventh Circuit affirmed dismissal of an ERISA § 502(a) claim where the…
Fourth Circuit Affirms Termination of Retiree Welfare Benefits Where Plan Reserved Right to Amend or Terminate
In Fitzwater v. Consol Energy, Incorporated, No. 24-2088, 2026 WL 595435 (4th Cir. Mar. 3, 2026), the Fourth Circuit affirmed a district court’s rulings largely in favor of CONSOL Energy…
Second Circuit Affirms Denial of Residential Mental Health Treatment and Limits Reach of Wit Under Arbitrary-and-Capricious Review
In Savage v. Rabobank Med. Plan, No. 24-2759-CV, 2026 WL 303600 (2d Cir. Feb. 5, 2026), the Second Circuit affirmed summary judgment in favor of an ERISA medical plan, holding…
Northern District of California Vacates Prior Remedies and Enters Sweeping Injunctive Relief Against United Behavioral Health for Fiduciary Breaches in Guideline Development
In Wit v. United Behavioral Health, No. 14-CV-02346-JCS, 2026 WL 290352 (N.D. Cal. Feb. 3, 2026), the Northern District of California issued an amended remedies order in this long-running litigation,…
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…
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