June 25, 2019

June 25, 2019

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June 24, 2019

Subscribe to Latest Legal News and Analysis

ERISA Administrative Appeal Barred As Untimely

The First Circuit held that a plaintiff failed to timely exhaust her administrative remedies under a long-term disability plan because the plan’s 180-day time limit for submitting appeals commenced on the date the plaintiff received notice of the decision that it was going to terminate her long-term disability benefits, not the actual date her benefits were terminated.  In so ruling, the Court rejected plaintiff’s argument that the doctrine of substantial compliance and the state’s notice-prejudice rule somehow excused her late-filed appeal.  The Court first concluded that the doctrine of substantial compliance, which is sometimes used by a plan administrator to excuse a failure to comply perfectly with ERISA’s notice requirements, could not be used by the plaintiff to excuse her late filing because such an expansion of the doctrine would render it “effectively impossible” for plan administrators to enforce administrative deadlines.  The Court also concluded that the plaintiff could not invoke the state’s common law notice-prejudice rule, which requires an insurer to show that it was prejudiced by an untimely notice of appeal in order to deny certain types of claims, because doing so would undercut the policy purposes behind the exhaustion requirement.  The case is Fortier v. Hartford Life & Accident Ins. Co., No. 18-1752, 2019 WL 697989 (1st Cir. Feb. 20, 2019).

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About this Author

Kyle Hansen Employment lawyer Proskauer
Associate

Kyle Hansen is an associate in the Labor & Employment Law Department and a member of the ERISA Litigation Group.

Kyle graduated summa cum laude from the University of Mississippi School of Law, earning his J.D. and two honors diplomas in the areas of Space & Aviation Law and Business Law. During law school, he won the North American Championship at the 2017 International Manfred Lachs Space Law Moot Court Competition, also winning “best brief.” He went on to represent North America at the world competition and was runner-up. Kyle also served as the senior editor for the ...

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