![]() Under ERISA, the administrative claims process supplants a trial. The “administrative record” consists of whatever documents and information were gathered and/or considered by the claims fiduciary during the administrative claims process when making the challenged benefit determination. The court will review the “administrative record” and determine whether the claim fiduciary’s decision to deny benefits was reasonable. For instance, a lawsuit alleging the wrongful denial of benefits will be adjudicated based on dispositive motions submitted by both parties. Reasonable attorney’s fees may also be recoverable, at the discretion of the court, assuming the plaintiff can satisfy ERISA’s legal standards. For the most part, a successful plaintiff challenging a benefit denial will be entitled to recover the amount of the benefit due under the terms of the plan. A plaintiff cannot recover punitive damages, damages for pain and suffering, or other types of state law damages. ERISA’s broad preemptive effect means that (1) most state actions are removable to federal court, even if no federal claim appears in the complaint, and (2) any state law claims relating to an ERISA benefit plan (think breach of contract, negligence, bad faith, misrepresentation or fraud) are preempted and subject to dismissal. Because ERISA is intended to provide an exclusive set of remedies, it preempts state law claims that relate to ERISA plans. Providing Employers with Strategic Advantages in LitigationĮRISA has its own civil enforcement scheme, and the universe of claims available to potential litigants is limited. In this article, we break down some of ERISA’s complexities and highlight its key rules of engagement. Knowledge of these rules can be invaluable in ensuring ERISA compliance, identifying risk and aiding in defense or litigation strategies. The Employee Retirement Income Security Act (ERISA) can be daunting. Important Considerations for In-House Counsel and Benefits Professionals
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