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Ninth Circuit Affirms Judgment for ERISA Plaintiff in Dispute Over Residential Mental Health Treatment

Ninth Circuit Affirms Judgment for ERISA Plaintiff in Dispute Over Residential Mental Health Treatment

In Dan C. v. Directors Guild of America - Producer Health Plan, No. 24-3203, 2025 WL 1419920 (9th Cir. May 16, 2025), the Ninth Circuit Court of Appeals reviewed the…

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Sixth Circuit Clarifies Insurer vs. Fiduciary Capacity in ERISA Dispute

In Bluecross Blueshield of Tennessee, Inc. v. Nicolopoulos, No. 24-5307, 2025 WL 1338242 (6th Cir. May 8, 2025), the Sixth Circuit Court of Appeals addressed an issue central to the…

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First Circuit Finds Wrongful Death Claim Related to Health Insurance Benefit Denial Is Preempted by ERISA

In Cannon v. Blue Cross & Blue Shield of Massachusetts, Inc., No. 24-1862, __F.4th__, 2025 WL 855194 (1st Cir. Mar. 19, 2025) (Before: Aframe, Lynch, and Howard, Circuit Judges), the…

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District Court Orders Inclusion of External Medical Review Documents in ERISA Administrative Record

In Noelle E. v. Cigna Health & Life Ins. Co., 2:23-cv-00686, 2025 WL 754031 (D. Utah Mar. 10, 2025), in a medical benefits action brought under the Employee Retirement Income…

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Ninth Circuit Affirms Denial of Coverage for Residential Treatment, Finding Plan Administrator’s Reliance on InterQual Criteria to be Reasonable

In K.K.; I. B. v. Premera Blue Cross, et al., No. 23-35480, 2025 WL 415721 (9th Cir. Feb. 6, 2025), Plaintiffs, K.K. and her daughter I.B., sought recovery of benefits…

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Seventh Circuit Affirms ERISA Fund’s Denial of Out-of-Network Medical Treatment

In Est. of Gifford v. Operating Eng’rs 139 Health Benefit Fund, No. 23-3356, __F.4th__, 2025 WL 79102 (7th Cir. Jan. 13, 2025), the Seventh Circuit Court of Appeals affirmed the…

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