Join The Conversation
Aba Heiman 11/17/2008 01:47 PM
You read my mind! As I was reading Wachtel, it occurred to me that the next case where an insurance company argues for discretionary authority in the Third Circuit should be challenged because Wachtel says they're looking out for their shareholders' interests and have an inherent conflict of interests, so why defer to their decision to decline benefits?
Brian S. King 11/17/2008 01:47 PM
Aba, the longer I practice in this area the more convinced I am that the federal judiciary has completely missed the boat in ERISA cases that deal with benefits under fully insured group health, life or disability policies. In that situation, judges should simply adopt, wholesale, those well-established principles of insurance law developed over many decades by state and federal courts across the country applying state law insurance principles. It wouldn't be difficult; those principles are found in fairly comprehensive and well-established fashion in such treatises as Couch on Insurance, Applemans', etc. Such an analysis is especially justified and appropriate given the language of the savings clause at 29 U.S.C. Sec. 1144(b)(2)(A).
Post A Comment
- Posted on 05/17/2011 CIGNA v. Amara
- Posted on 03/29/2011 Bloomberg Markets' article on ERISA
- Posted on 12/24/2010 James F. v. CIGNA Behavioral Health Inc.
- Posted on 07/11/2019 Timothy D. v. Aetna Health and Life Ins. Co.
- Posted on 06/24/2019 Family says insurance fails to pay for mental health coverage despite medical necessity
- Posted on 04/24/2006 Eliminating Discretionary Clauses in Insurance Policies