In Smith v. Dressler, the Supreme Court for the State of New York in Suffolk County addressed a personal injury case where an injured plaintiff brought suit against homeowners after he was injured when he fell from a ladder while performing roofing and siding work. In his Complaint, he alleged common law negligence and violations of Labor Law §§ 200, 240 and 241. Defendants filed a motion for summary judgment, arguing that the single-family homeowner’s exemption applies as to the Labor Law claims because defendants did not supervise, direct or control plaintiff’s work and did not provide him with any
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Archives for Disability Insurance
Third Circuit Holds ERISA Plan Administrator Must Inform Claimant of Plan-Imposed Deadline for Judicial Review in Notification Denying Benefits
In Mirza v. Insurance Administrator of America, Inc., 2015 WL 5024159, (3d Cir. Aug. 26, 2015), the Court of Appeals addressed the principal question of whether under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. plan administrators must inform claimants of plan-imposed deadlines for judicial review in their notifications denying benefits. 29 C.F.R. § 2560.503-1(g)(1)(iv) provides that when a plan administrator denies a request for benefits, it must set forth a “description of the plan’s review procedures and the time limits applicable to such procedures, including a statement of the claimant’s right to
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Pennsylvania Federal Court Finds That Illegal Passing Does Not Trigger the Criminal Act Exclusion of an Accidental Death Policy
In Locklear v. Sun Life Assurance Company of Canada, the United States District Court for the Middle District of Pennsylvania held that an insurer could not use alleged vehicle code violations to trigger the “criminal act” exclusion of an accidental death policy. The insurer denied benefits to the widow of a man who was killed in a car accident when the motorcycle he was riding collided with a truck while he was attempting to pass a construction vehicle in a no-passing zone. Plaintiff brought suit under ERISA after the insurer denied her claim and she exhausted all her administrative appeals.
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Pennsylvania Superior Court Holds That Fraudulent Acts Exclusion Precludes Liability Coverage for ERISA Class Action
The Pennsylvania Superior Court has held that pursuant to a fraudulent acts policy exclusion, a policyholder was not entitled to liability coverage for a class action verdict arising from the policyholder’s misleading description of an ERISA benefits plan. In Cigna Corp. v. Executive Risk Indem., Inc.,the policyholder sought coverage for a class action challenging the policyholder’s 1998 conversion of its defined benefit pension plan to a cash balance plan. This conversion had the effect of freezing or reducing the benefits of some participants. While a trial court determined that the conversion did not violate ERISA, the court also found that
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