Mar 232016

In 2014, the Sixth Circuit held that a disability insurer intent on asserting a statute of limitations defense (that is, a defense founded upon the position that the claim asserted against it is time-barred) had better be able to prove that it mentioned the time limitation in the letter through which it advised the claimant that benefits were being denied or terminated.  Moyer v. Metropolitan Life Ins. Co., 762 F.3d 503 (6th Cir. 2014).  A year later, the Third Circuit followed suit in Mirza v. Insurance Adm’r of Am., Inc., 800 F.3d 129 (3d Cir. 2015).

On March 14, 2016, the First Circuit weighed-in, holding (consistent with Moyer and Mirza) that in order not to run afoul of 29 C.F.R. § 2560.503-1(g)(1)(iv), a disability insurer must apprise its insured of the applicable time limit in its denial letter.  If it fails to do so, held the court, the defense is lost.

Santana-Diaz v. Metropolitan Life Ins. Co., 816 F.3d 172 (1st Cir. 2016)

 Leave a Reply

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>