ERISA Litigation – Life and Disability Claims
GSB has extensive experience representing life and disability insurers and self-funded welfare benefit plans in lawsuits concerning disability, accidental death and life insurance claims. We have successfully defended our clients in both the Federal District Courts and the United States Court of Appeals for the Sixth Circuit.
ERISA benefit litigation requires knowledgeable attorneys who can recognize and resolve the numerous and often complex issues in an area of law that has produced volumes of reported and unpublished decisions throughout all levels of federal courts. Those issues might include: safe harbor provisions and whether ERISA applies; compliance with notice and procedural requirements in claim administration; preemption of state law claims, including allegations of bad faith; limits on the scope of discovery; identification of the proper content of the Administrative Record; application of the proper standard of judicial review; equitable versus legal remedies; and procedural nuances involved in presenting matters to the Court for resolution. GSB also has extensive experience in negotiating settlement of ERISA benefit claims directly with claimants’ counsel, via mediation or through settlement conferences with the Courts.
In its purest form, ERISA litigation is coverage litigation. Whether the plan is insured or self-funded, claim resolution involves application of the federal ERISA statutory framework to the employer-sponsored benefit plan or policy, with certain gaps filled by federal common law. The United States Supreme Court has stated that
‘[n]othing in ERISA requires employers to establish employee benefits plans. Nor does ERISA mandate what kind of benefits employers must provide if they choose to have such a plan.’ . . . Rather, employers have large leeway to design disability and other welfare plans as they see fit.
Black & Decker Disability Plan v. Nord, 538 U.S. 822, 833, 123 S.Ct. 1965 (2003)(citation omitted). Defending plans or insurers against claims requires the ability to interpret and apply both plan language, developed at the discretion of the plan sponsor, and the ERISA statutes. Our attorneys have over twenty years of experience representing insurers in coverage and bad faith litigation. We have added to that coverage experience over ten years of working knowledge of ERISA law to merge these specialties and better serve our clients.
GSB also represents insurers concerning life, accidental death and disability policy claims that are not governed by ERISA. For those actions, we are able to apply years of experience trying personal injury cases, contract disputes, coverage issues and bad faith claims.
Our attorneys have also gained in-depth knowledge of ERISA subrogation issues which are arising with increasing frequency in tort and insurance litigation, both ERISA and non-ERISA.
