Does a Late ERISA Appeal Decision Cost the Insurer Deference? Court Reviews Hartford’s Long-Term Disability Denial De Novo and Vacates It

In Farley v. Hartford Life and Accident Insurance Company, No. 4:24-cv-00894-SEP, 2026 WL 2971836 (E.D. Mo. Sept. 30, 2026), the United States District Court for the Eastern District of Missouri granted summary judgment to an ERISA long-term disability claimant, holding that Hartford forfeited deferential review when it missed the 45-day deadline to decide her appeal, and that its denial of benefits under the policy’s “Any Occupation” standard could not survive de novo review. The court vacated the denial and remanded for a renewed, full, and fair review.

Why did the court review Hartford’s ERISA denial de novo?

The plan gave Hartford discretionary authority to determine eligibility, which ordinarily means a court reviews a denial only for abuse of discretion. The 2016 amendments to the ERISA claims-procedure regulations changed that calculus for disability claims. Those amendments require a plan to “strictly adhere” to all claims-processing requirements, including the 45-day deadline to decide a disability appeal under 29 C.F.R. § 2560.503-1(i). When a plan fails to strictly adhere and the claimant sues, the claim is “deemed denied… without the exercise of discretion,” and the court reviews it de novo.

The court found that Hartford received Plaintiff’s appeal by fax to the correct number on August 30, 2023, and did not issue a decision within 45 days. Hartford’s own correspondence undercut its position: it twice apologized for the delay in handling the appeal it acknowledged receiving “on 8/30/2023,” then later argued it had not actually received the appeal until November because Plaintiff used a wrong mailing address and an incorrect claim number. The court held that the timely, correctly addressed fax satisfied the appeal requirements, so Hartford’s arguments about the mailing were beside the point. Because Hartford decided outside the time the regulations and the plan allowed, it did not act within the bounds of its conferred discretion.

The court distinguished McIntyre v. Reliance Standard Life Insurance Company (8th Cir. 2020), on which Hartford relied, because that decision applied the earlier 2002 regulations, under which delay was merely a factor in abuse-of-discretion review. The Eighth Circuit has not yet interpreted the amended regulations, but the court observed that for claims filed after April 1, 2018, the text requires strict adherence, aligning with Cogdell v. Reliance Standard Life Insurance Company (4th Cir. 2026) and Fessenden v. Reliance Standard Life Insurance Company (7th Cir. 2019).

Did Hartford’s late decision qualify as a “de minimis” violation?

The amended regulations preserve deference despite a procedural violation only through a narrow de minimis exception, and only if all five conditions are met: the violation is de minimis, it does not cause harm, it results from good cause or matters beyond the plan’s control, it occurs during a good-faith exchange of information, and it is not part of a pattern or practice. The court assumed the delay might be de minimis but found Hartford failed the remaining prongs. Plaintiff was likely prejudiced by the additional time spent waiting on her benefit determination, Hartford established no good cause for missing the deadline, and its attempt to blame Plaintiff for a processing failure within its own control cut against any finding of good cause. The exception did not apply, and de novo review governed.

What evidence did the court consider on de novo review?

Because Plaintiff’s appeal was deemed denied on October 14, 2023, the administrative record closed on that date. The court therefore reviewed the May 30, 2023 denial that Plaintiff had appealed, and held that Hartford’s later December 6, 2023 decision and its accompanying employability analysis were not properly before the court.

Why did the court reject Hartford’s “Any Occupation” analysis?

After 24 months of benefits, the policy required Plaintiff to be disabled from “Any Occupation,” defined as any occupation for which she is “qualified by education, training or experience” and that meets an earnings threshold. Hartford’s vocational analysis, prepared by Cathleen Crovo, identified four occupations Plaintiff could perform “with minimum training”: Claims Clerk II, Rehabilitation Clerk, Dispatcher, and Checker II.

The court found two problems. First, the plan’s definition does not permit requiring retraining; it reaches only occupations for which the claimant is already qualified by education, training, or experience. Second, even if the plan allowed retraining, the analysis never explained how much training Plaintiff would need, what skills she lacked, or what she would have to acquire to become eligible. The court drew on Gully v. Aetna Life Insurance Company (W.D. Ark. 2014), where a vocational report’s unexplained assumption of “minimal” training was insufficient even under the more deferential abuse-of-discretion standard. Relying on occupations that require retraining contravened the plan’s language and therefore ERISA.

How did Hartford’s own reviewing physician undermine the denial?

Hartford’s vocational analysis concluded Plaintiff could perform sedentary work. Under the Dictionary of Occupational Titles, sedentary work requires standing and walking “occasionally,” meaning up to one-third of an eight-hour day, or roughly two hours and forty minutes. Hartford’s own reviewing physician, Dr. Fadul, limited Plaintiff to standing and walking up to one hour per day in 20-minute intervals. Even reading his report in the light most favorable to Hartford, so that Plaintiff could stand for one hour and walk for one hour, that is two hours total, less than the sedentary threshold. The court rejected Hartford’s reliance on a District of Minnesota footnote later reversed on other grounds (Pralutsky v. Metropolitan Life Insurance Company) and a Second Circuit decision for the proposition that sedentary work caps standing and walking at two hours. Because a claimant who cannot meet the exertional demands of sedentary work cannot meet them for any work, Hartford’s denial ignored the limitations set by its own doctor.

What did the court order?

The court granted Plaintiff’s motion for summary judgment, denied Hartford’s cross-motion as moot, vacated the denial of benefits, and remanded to Hartford for a renewed, full, and fair review consistent with its order. The court stated that if Hartford cannot identify any occupation Plaintiff can perform, she is entitled to disability benefits under the plan.