On June 9, the long-awaited revised "fiduciary rule" from the U.S. Department of Labor ("DOL") went into partial effect and will be in full force as of January 1, 2018. After nearly a decade, and much political wrangling, the updated rule ushers in sweeping changes regarding the duties and responsibilities financial advisors and others owe their clients.
The Supreme Court - presented with a simple question about ERISA's fiduciary-duty statute of limitations (29 U. S. C. § 1113) - lays the foundation for a potential new round of litigation about how strictly and often plan fiduciaries must monitor the performance of their retirement investment plans. The Court, without dissent, agrees that there is no set-it-and-forget-it rule for fiduciaries.
The duty of the administrator of a short-term disability (or other welfare benefit) plan can sometimes extend beyond reviewing the participant's submitted claim. The Fourth Circuit holds that it can also be an abuse of discretion for the administrator to disregard "readily available material evidence of which it was put on notice." Here, the administrator allegedly failed to follow up on a notation in the medical file indicating that the participant's recent widowhood "could have triggered PTSD caused by the [recent] death of her mother and children."
Seven years into litigation, plaintiff James Killian is a little closer to achieving justice for his late wife. After litigating an ERISA case unsuccessfully before two federal district court judges and a Seventh Circuit panel, the full Seventh Circuit today holds that Mr. Killian may pursue a claim for himself and his spouse's estate against her health care plan. He alleges that the plan misled them about whether Ms. Killian's end-stage care was within network, in breach of the duty of prudence under 29 U.S.C. § 1104(a)(1)(B). The court affirms that the ERISA duty of prudence requires complete disclosure by the plan administrator, "even if that requires conveying information about which the beneficiary did not specifically inquire."
An employee is informed by an employer health plan that surgery is approved, only to learn afterwards that the plan changed its mind and refused to pay over $77,000 in bills. The occasion of these simple and all-too-common facts gives the Seventh Circuit an opportunity to apply the recent U.S. Supreme Court decision Cigna Corp. v. Amara, 131 S. Ct. 1866 (2011). It holds that Cigna "substantially changes our understanding of the equitable relief available under section 1132(a)(3)" and expands judicial options for remedies, including monetary relief.