{"id":4088,"date":"2026-04-05T04:12:37","date_gmt":"2026-04-05T04:12:37","guid":{"rendered":"https:\/\/www.insuracarelife.com\/blog\/the-friday-five-five-erisa-litigation-highlights-april-2026-saul-ewing-llp\/"},"modified":"2026-04-05T04:12:37","modified_gmt":"2026-04-05T04:12:37","slug":"the-friday-five-five-erisa-litigation-highlights-april-2026-saul-ewing-llp","status":"publish","type":"post","link":"https:\/\/www.insuracarelife.com\/blog\/the-friday-five-five-erisa-litigation-highlights-april-2026-saul-ewing-llp\/","title":{"rendered":"The Friday Five: Five ERISA Litigation Highlights – April 2026 | Saul Ewing LLP"},"content":{"rendered":"
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This issue of the Friday Five<\/em> discusses the Fifth Circuit\u2019s strict approach to review deadlines, a court chiding an administrator for relying on evidence not in the record, a court\u2019s refusal to permit discovery into claims statistics, rescission of a life insurance policy due to misrepresentations in the application, and holding an administrator strictly to administrative appeal timelines.<\/p>\n

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  1. Fifth Circuit Strips Administrator of Discretionary Review Standard for Untimely Decision<\/strong>
    The Fifth Circuit held that an administrator that fails to issue a timely decision during an administrative appeal of a disability benefits claim is not entitled to the deferential standard of review under ERISA, at least within the circumstances of the Cogdell case. \u00a0During the administrative appeal, the administrator told the claimant that the review would exceed the usual 45-day deadline, but failed to state the additional time necessary or otherwise explain the special circumstances to support an extension of time. \u00a0The administrator eventually issued its denial 72-days after the appeal was filed. \u00a0The appellate court determined that, as a \u201cconsequence\u201d of the untimely decision and failure to support an extension of time, the administrator\u2019s decision should be evaluated under the de novo standard. \u00a0The Fifth Circuit affirmed the trial court\u2019s grant of summary judgment to the claimant.
    Cogdell v. Reliance Standard Life Ins. Co., No. 25-1083, 2026 WL 588427 (Mar. 3, 2026 5th Cir.)<\/strong><\/em><\/li>\n
  2. Court Finds Abuse of Discretion for Reviewer\u2019s Conclusions Not Supported by Record<\/strong>
    The district court, in granting summary judgment for the claimant in an ERISA long-term disability benefits dispute, criticized the administrator on multiple fronts. \u00a0For example, the court held that the administrator should not have required objective evidence for a subjective chronic pain complaint, failed to engage an independent medical examination, neglected to perform a vocational review, and otherwise took multiple missteps in the review process. \u00a0The court took particular interest in an independent reviewer hired by the administrator, who concluded that the plaintiff could have performed her regular occupation based on the claimant\u2019s frequent travel out-of-state to care for sick family members. \u00a0These trips, however, were not supported by the record, which led the court to exhibit \u201ca high level of skepticism\u201d of the administrator\u2019s process. \u00a0The trial court found that the administrator abused its discretion due to the number of issues during the review process.
    Guy v. Reliance Standard Life Ins. Co., No. 24-293, 2026 WL 539534 (Feb. 20, 2026 D. Ariz.)<\/strong><\/em><\/li>\n
  3. Discovery Into Claim Reviewer Statistics Deemed Off Limits<\/strong>
    The plaintiff moved to compel discovery related to the number of claims terminated or denied by a physician reviewing the plaintiff\u2019s claim on behalf of the administrator. \u00a0The federal magistrate judge denied the motion and the plaintiff appealed. \u00a0The district judge agreed with the denial of discovery, holding that the plaintiff failed to establish bias to create a threshold need for discovery, while such discovery would not show any procedural defect in the review process. \u00a0The court agreed with prior Seventh Circuit precedent, which reasoned that the court was only concerned with the plaintiff\u2019s specific case, not general statistics unrelated to the particular denial before the court, even if the same medical reviewer was involved in all of the cases.
    Schulmeier v. Lincoln Nat\u2019l Life Ins. Co., No. 24-284, 2026 WL 668269 (Mar. 9, 2026 N.D. Ind.)<\/strong><\/em><\/li>\n
  4. Court Allows Administrator to Rescind Policy Based on Misrepresentations in Application<\/strong>
    In an ERISA life insurance dispute, the claimant marked \u201cno\u201d to policy application questions regarding prior illicit drug or alcohol use. \u00a0After the plaintiff\u2019s death, it became clear that the application response was false as the plaintiff had a well-documented history of drug abuse throughout his medical records. \u00a0In fact, the claimant\u2019s death was caused by a drug overdose. \u00a0The administrator rescinded the coverage based on this misrepresentation and the district court granted summary judgment to the insurer. \u00a0The court had little trouble finding that the misrepresentation occurred and afforded the insurer grounds to rescind coverage. \u00a0The court also rejected the claimant\u2019s related arguments, finding that the insurer was not required to establish intent to deceive by the insured, while the insurer was further not required to reimburse the claimant for his insurance premiums as a condition precedent to rescission.
    Florentino v. Hartford Life & Accid. Ins. Co., No. 24-643, 2026 WL 751918 (W.D. Ky. Mar. 17, 2026)<\/strong><\/em><\/li>\n
  5. Administrator Violated Claims Regulations by Waiting for Medical Records<\/strong>
    In an ERISA long-term disability benefits dispute, the administrator moved for summary judgment on the plaintiff\u2019s failure to exhaust administrative remedies, reasoning that the claimant filed litigation before the administrator had a chance to rule on administrative appeal. \u00a0The administrator argued that the time period to determine the appeal was tolled because it was awaiting medical records from the plaintiff. \u00a0The district court held, however, that tolling only applies when the administrator is waiting for records directly from the plaintiff. \u00a0In this case, the records were due from the plaintiff\u2019s medical providers, not the plaintiff directly. \u00a0The court further determined that the administrator failed to invoke any extension of the review time period because, even if it was waiting for information from one of the plaintiff\u2019s providers, it should have continued to move the review process forward. \u00a0The court denied the administrator\u2019s motion for summary judgment and scheduled the matter for a bench trial.
    Bianchini v. Hartford Life & Accid. Ins. Co., No. 25-6535, 2026 WL 810303 (SDNY Mar. 24, 2026)<\/strong><\/em><\/li>\n<\/ol>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    This issue of the Friday Five discusses the Fifth Circuit\u2019s strict approach to review deadlines, a court chiding an administrator for relying on evidence not in the record, a court\u2019s refusal to permit discovery into claims statistics, rescission of a life insurance policy due to misrepresentations in the application, and holding an administrator strictly to […]<\/p>\n","protected":false},"author":1,"featured_media":4089,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4088","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/posts\/4088","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/comments?post=4088"}],"version-history":[{"count":0,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/posts\/4088\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/media\/4089"}],"wp:attachment":[{"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/media?parent=4088"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/categories?post=4088"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.insuracarelife.com\/blog\/wp-json\/wp\/v2\/tags?post=4088"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}