Defending Against ERISA Wrongful Denial of Benefits Claims: Procedural and Substantive Strategies
Navigating ERISA's Procedural Prerequisites; Leveraging Defenses of Lack of Standing, Contractual Time Limits, Exhaustion and More
Recording of a 90-minute CLE webinar with Q&A
Conducted on Wednesday, December 14, 2016
Recorded event now available
This CLE webinar will provide guidance to employee benefits counsel for defending against wrongful denial of benefits claims involving ERISA plans. The panel will explain the administrative process required under ERISA before litigation may proceed. The panel will also discuss how courts are addressing key procedural and substantive issues, including standing, contractual time limits, exhaustion of administrative remedies, discovery, standards of review, deference to the administrator’s decision, attorneys’ fees and preemption.
ERISA litigation remains steady, including cases brought by plan participants, beneficiaries and providers challenging denials of benefits. Defending benefits denial cases involves a number of procedural and substantive strategies.
Counsel must be vigilant about identifying removal opportunities, as well as leveraging other effective defense strategies. Potential tools in the defense attorney’s arsenal include lack of standing, preemption, failure to exhaust administrative remedies, expiration of the statute of limitations and claims-based limitations defenses.
Effective plan design, careful structuring of the administrative process, and informed guidance to those who administer claims can greatly increase the precision of claims administration and maximize the likelihood of success in benefits denial litigation. Advanced preparation by counsel may result in fewer disputes over discovery, conflicts of interest, standards of review and deference accorded the administrator’s decision, and may even reduce attorneys’ fees.
Listen as our authoritative panel of ERISA litigators provides counsel with best practices for navigating key issues in defending benefit denial suits. The panel will also discuss key case law developments in benefits suits.
- Exhaustion of administrative remedies (including ACA claims review)
- Standard of review
- State law preemption and removal
- Statute of limitations and other procedural issues
- Scope of conflict discovery and other discovery practices
- Attorneys’ fee awards and remedies
The panel will review these and other key issues:
- How can plans preserve and maximize their procedural and substantive defenses through plan design?
- What has been the impact of recent case law on the review of claim administrators’ determinations?
- What are best practices for preparing during the administrative process for responding to conflict discovery, and protecting the administrative record?
Ronald M. LaRocca, Esq.
Mr. LaRocca represents businesses in a wide range of matters spanning multiple practice areas, including ERISA, construction and energy disputes. He has experience representing businesses in a variety of commercial contexts and concentrates his practice in providing practical solutions for clients. Mr. LaRocca is a member of the firm's Litigation Group and regularly practices before regulatory agencies and state and federal courts.
Medora A. Marisseau, Shareholder
Karr Tuttle Campbell,
Ms. Marisseau provides employment, ERISA and employee benefits advice and litigation services to large and small employers throughout the Pacific Northwest and Alaska. She represents employers, plan administrators, insurers and other plan fiduciaries to ensure their compliance with ERISA, HIPAA and COBRA. A substantial portion of Ms. Marisseau’s practice is devoted to defending clients in ERISA benefit and fiduciary liability claims.
Nancy Pridgen, Counsel
Patel Burkhalter Law Group,
Ms. Pridgen focuses her practice on employment litigation in the federal courts, and has handled, in some capacity, nearly every type of employment law matter that exists. She sub-specializes in ERISA litigation, and has litigated scores of ERISA benefits claims and fiduciary cases throughout the country.
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