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Second Circuit: Insurer's Internal Remand Did Not Extend Benefit Determination Deadline

June 15, 2022 11:06 AM | OEHA (Administrator)

In a dispute involving long-term disability benefits under a plan governed by the Employee Retirement Income Security Act of 1974 (ERISA), the US Court of Appeals for the Second Circuit concluded that a benefit determination on administrative review under the Department of Labor's (DOL) claims regulations must decide with finality whether a claimant is entitled to benefits. The court rejected the insurer's argument that the DOL's regulations afforded the insurer flexibility and additional time to remand the matter for further internal consideration.

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