Ninth Circuit: An ERISA Administrator Cannot Rescue a Benefits Denial with a Plan Provision It Never Cited
Ninth Circuit: An ERISA Administrator Cannot Rescue a Benefits Denial with a Plan Provision It Never Cited
In Roggenkamp v. Morgan Stanley Medical Plan, No. 24-7864, 2026 WL 1625357 (9th Cir. June 5, 2026), Plaintiff Roggenkamp sued the Morgan Stanley Medical Plan (“MS Plan”) under ERISA §…
Tenth Circuit Dismisses ERISA Appeal as Non-Final Where District Court Remanded Benefits Determination to Plan Administrator
In Kirsten W. v. California Physicians’ Service, No. 25-4029, 2026 WL 1433128 (10th Cir. May 21, 2026), the Tenth Circuit dismissed an appeal from an ERISA mental-health benefits dispute, concluding…
Second Circuit Affirms Dismissal of Out-of-Network Provider’s ERISA Claim Where Provider Failed to Establish Beneficiary Status or Valid Assignment and Abandoned Claim on Appeal
In Emsurgcare, Emergency Surgical Assistant v. Hager, No. 25-1975-CV, 2026 WL 1378672 (2d Cir. May 18, 2026), Plaintiffs-Appellants Emsurgcare and Emergency Surgical Assistant (together, “Emsurgcare”) provided emergency surgical services to…
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…
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