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Ninth Circuit Declines to Apply California's Insurance Notice-Prejudice Rule to a Benefits Claim Against a Self-Funded ERISA Plan
Seyfarth Shaw LLPLink to more items from this source
June 17, 2015

"The Court of Appeals determined that the Plan's one-year claim submission deadline was reasonable and did not conflict with ERISA. While recognizing a general federal judicial duty to formulate federal common law to supplement the provisions and purposes of ERISA, the Court of Appeals found that no such judicial legislation was required.... California's notice-prejudice rule is exclusively a creature of state insurance law. The Court of Appeals concluded that extending an insurance-based rule to uninsured plans, such as the Plan at issue, would defeat the distinction Congress made between insured and uninsured plans." [Zagon v. Am. Airlines, Inc. LTD Plan, No. 13-55866 (9th Cir. May 21, 2015) ]

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