29 C.F.R. §2560.503-1 - Claims procedure
| Cite as | 29 C.F.R. §2560.503-1 |
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2414 cases
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Dual Diagnosis Treatment Ctr., Inc. v. Blue Cross California, Case No.: SA CV 15-0736-DOC (DFMx)
...not medical providers). Because Plaintiffs are beneficiaries seeking benefits, they argue they would also be claimants as defined in 29 C.F.R. § 2560.503-1. After exhausting administrative remedies, a claimant can "pursue any available remedies under [ERISA] on the basis that the plan has f......
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Moyle v. Liberty Mut. Ret. Benefit Plan, CASE NO. 10cv2179–GPC(MDD)
...to benefits under the plan pursuant to 29 U.S.C. § 1132(a)(1)(B), promissory estoppel, and denial of claim rights afforded under 29 C.F.R. § 2560.503–1(h)(2)(i). (Dkt. No. 3.) On April 25, 2011, District Judge Dana Sabraw denied Defendants' motion to dismiss the second and third claims; gra......
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Doe v. CVS Pharmacy, Inc., Case No. 18-cv-01031-EMC
...1133(2). Regulations set forth the minimum requirements that employee benefit plans must include to ensure a full and fair review. See 29 C.F.R. § 2560.503-1(a) – (o).Plaintiffs allege they were denied a full and fair review by CVS's "fail[ure] to provide a reasonable procedure for opting-o......
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Hall v. National R.R. Passenger Corp.
..."copies of, all documents, records, and other information relevant to Page 46 [Plaintiffs'] claim for benefits," as required by 29 C.F.R. § 2560.503-1(h)(2)(iii) during the course of the administrative review process. Hall II Compl. ¶ 71 (quoting 29 C.F.R. § In light of the interrelation of......
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111 firm's commentaries
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The ERISA Litigation Newsletter - June 2012
...607 F.2d 427 (6th Cir. 2010). [21] Id. at 431. [22] Originally published by Bloomberg Finance L.P. Reprinted with permission. [23] See 29 C.F.R. § 2560.503-1. [24] See, e.g., Wert v. Liberty Life Ins. Co. of Boston, 447 F.3d 1060, 1062, 37 EBC 2261 (8th Cir. 2006) (97 PBD, 5/19/06; 33 BPR 1......
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The ERISA Litigation Newsletter - November 2011
...1866 (2011); and reconciling obligations relating to the production of documents under ERISA § 104(b)(4) versus the claims regulation, 29 C.F.R. § 2560.503-1. As always, be sure to review the section on Rulings, Filings, and Settlements of "Never Mind" – DOL Withdraws Proposed Regulation on......
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The ERISA Litigation Newsletter - November 2011
...1866 (2011); and reconciling obligations relating to the production of documents under ERISA § 104(b)(4) versus the claims regulation, 29 C.F.R. § 2560.503-1. As always, be sure to review the section on Rulings, Filings, and Settlements of "Never Mind" – DOL Withdraws Proposed Regulation on......
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The ERISA Litigation Newsletter - November 2012
...procedures helps reduce frivolous lawsuits, promote consistency, and provide a non-adversarial method of claims settlement). [4] See 29 C.F.R. § 2560.503. [5] E.g., Kennedy v. Empire Blue Cross & Blue Shield, 989 F.2d 588, 594 (2d Cir. 1993) (noting the "firmly established federal policy fa......
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16 books & journal articles
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An assessment of new appeals and external review processes - ERISA claimants get 'some kind of a hearing'.
...PHS Act section 2719 provides that plans and issuers must initially incorporate the internal claims and appeals processes set forth in 29 C.F.R. 2560.503-1 (i.e., the 2000 claims regulations) and update these processes as required by the DOL. (11) Thus, the prior DOL claims procedure regula......
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Table of Statutes
...C.F.R. § 1.186-1(c)(3)(II) (1993) ............................................................................................ § 8:540 29 C.F.R § 2560.503-1(g)(1)(iii) ............................................................................................ § 1:213.10 29 C.F.R § 2560.503......
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How to litigate an Erisa disability claim
...in this section with respect to a claim, the claimant is deemed to have exhausted the administrative remedies under the plan … .” 29 CFR 2560.503-1(l)(2)(i). his exception, however, does not apply if the failure was: (i) de minimis; (ii) non-prejudicial; (iii) attributable to good cause or ......
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'ERISA and NQDC'
...30ERISA § 4065(a). 31See ERISA § 3004. 32ERISA § 103(a)(3)(A). 33Id. § 103(a)(4)(A); § 103(d). 34ERISA § 503, 29 U.S.C. § 1133. 3529 CFR § 2560.503-1 36Amato v. Bernard, 618 F.2d 559 (9th Cir. 1980); Graham v. Federal Express, 725 F. Supp. 429 (W.D. Ark. 1989); but see Berger v. Edgewater S......
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