Back to the Future: U.S. Airways v. McCutchen
On April 16, 2013, the United States Supreme Court clarified how equitable principles interact with the plan language of self-funded ERISA health plans. The question presented to the Court was: Should the principles of “common fund,” often referred to as …
Vioxx Settlement Recipients May Be On Their Own For ERISA Lien Resolution
By Director of Lien Resolution
Families and individuals injured by Vioxx may still have lien claims to resolve despite the Lien Resolution Administrator’s attempt to manage these claims. In a December 4, 2012 ruling the United States District Court, E.D. …
Understanding the MSPRC Process
By Tal A. Wollschlaeger
Medicare Lien Analyst
Everybody expects to get paid back one way or another. Whether someone owes you money because you bought him or her lunch when times were tough or you owe money on your credit …
ERISA: Put New Teeth Into Plan Document Requests with 1024(b)(4)
One of the keys to properly defending against an asserted subrogation or reimbursement claim from an ERISA plan is making requests to the plan administrator. ERISA places certain responsibilities upon the plan administrator to assist with the proper management of …
From Roger Baron: 8th Circuit Exonerates Law Firm Doggedly Pursued for Liability on ERISA Reimbursement Claim
The 8th Circuit Court of Appeals handed down its decision in Treasurer, Trustees of Drury Industries v. Sean Goding, No. 11-2885. This is a situation where the ERISA plan doggedly pursued the law firm which had represented the …
ERISA Liens: How to turn the McCutchen gray into green for your client
By Vice President & Director of Lien Resolution
The uncertainty that exists regarding a self-funded ERISA plan’s ability to refuse reduction of their claim based upon equitable principles can be used to increase your client’s net recovery. A gray area …
From Roger Baron: “unclean hands” is equitable defense to claim under ERISA § 1132(a)(3) according to Oregon Federal Court
Reprinted with Permission of Roger Baron
In Ayers v. LINA, No. 6:08-cv-06287-AA, (D.Or. April 19, 2012), the court was adjudicating a dispute over LTD benefits under ERISA coverage. The plaintiff sued alleging wrongful denial and the ERISA insurer counterclaimed …
Outsourcing of Lien Resolution – The Florida Supreme Court’s Ruling on 4-1.5
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC
The purpose of this post is to inform Florida attorneys about the Florida Supreme Court’s rejection of the proposed amendment to Rule 4-1.5. Before discussing the Florida Supreme Court’s rejection, I first …
ERISA Beneficiary and His Wife Where Funds are in a Structured Settlement
Reprinted with Permission from Roger Baron
The 5th Circuit handed down ACS Recovery Services, Inc. v. Griffin today, April 2, 2012. Mr. Griffin was seriously injured in an auto accident. The ERISA plan paid medical bills of $50,076.19. The plaintiff’s …
From Roger Baron: Revictimization of Personal Injury Victims By ERISA Subrogation
Reprinted with permission from Roger Baron
“Subrogation on personal injury claims by a health insurer was universally prohibited by law when Congress enacted ERISA in 1974. Seizing upon the notion of ERISA preemption, ERISA plans and related insurers have manufactured …
