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In a world where the odds are stacked against the common man, the Supreme Court has again made a decision that makes it impossible for a person to seek justice.  Read below the story posted on LawyersandSettlements.com, and follow the links on that site for more information. This effects us all.

Supreme Court Sides with Plan in ERISA Lawsuit

January 3, 2014, 08:00:00AM. By Heidi Turner

Washington, DC: In a ruling on ERISA plan statutes of limitations as they relate to a company’s disability plan, the Supreme Court has sided with plan. The Supreme Court unanimously found that the limitations period does not violate the Employee Retirement Income Security Act. This means that plans are able to impose a statute of limitations even on ERISA-covered benefits plans.

Supreme Court Sides with Plan in ERISA LawsuitThe lawsuit (Heimeshoff Vs. Hartford Life and Wal-Mart Stores Inc, Case Number 12-729) involved disability insurance that was offered by the policyholder’s employer and therefore covered by ERISA. Under ERISA laws, a policyholder cannot file a lawsuit to appeal a denied claim until the insurance company’s appeals process has been exhausted.

 Julie Heimeshoff filed an insurance claim for long-term disability for lupus and fibromyalgia. She filed the claim in August 2005, but it was denied in November 2006. She appealed that decision in September 2007, but the appeal was denied again in November 2007. Heimeshoff then filed a lawsuit in November 2010.

 Hartford Life, the insurance company, argued that the lawsuit should have been filed within Connecticut’s three-year statute of limitations, which began running the day proof of loss was required by the insurance company. That would have left Heimeshoff with just under one year following the denial of her appeal to file the lawsuit. Based on that, Heimeshoff’s lawsuit, Hartford Life argued, was untimely and should have been dismissed. But Heimeshoff claimed the statute of limitations should not begin running until the insurer’s appeals process has been exhausted because a lawsuit cannot be filed until after that time.

Bloomberg BNA (12/17/13) notes that two lower courts disagreed with Heimeshoff, finding that the terms of the plan, including the statute of limitations, were valid. Heimeshoff took her case to the Supreme Court, which unanimously agreed with the lower courts. The Supreme Court found that as long as the statute of limitations period is reasonable, it is valid even if it begins running before a lawsuit can be filed.

Writing for the panel, Justice Clarence Thomas noted that the court “rejects the contentions of Heimeshoff and the United States that the limitations provision is unenforceable because it will undermine ERISA’s two-tiered remedial scheme.”

What this means for people with insurance plans covered by ERISA is that if those plans have a statute of limitations for filing a lawsuit, that period can begin running before the appeals process has been exhausted. Policyholders must be aware of the statute of limitations in their state or associated with their plan and know when that period begins running or they might not be able to file a lawsuit.

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Comment Preferences

  •  Tip Jar (8+ / 2-)

    Tired of living in a "RED" state...

    by deereigna on Fri Jan 03, 2014 at 10:40:20 AM PST

  •  While your diary says Clarence Thomas wrote (10+ / 0-)

    the panel's opinion, it does say it was a unanimous Supreme Court ruling.  Unless I'm mis-reading something here.  Sounds like there need to be multiple filings just in case one is turned down.

  •  I hate Thomas as much as anyone and yes he wrote (12+ / 0-)

    the decision but it was a unanimous. Kind of hard to late it solely at the feet of Thomas.

  •  A unanimous decision? (10+ / 0-)

    Kind of hard to blame one justice for that, even the one who wrote it.  If it's unanimous, that means all of them read it, agreed with it, and signed on to it.  He's the one who happened to put the unanimous view of all of them into an opinion.  

  •  If you're going to simply copy and paste (10+ / 0-)

    the writing of somebody else, you should (1) blockquote it and (2) provide a link to the original.

    Also, correct me if I'm wrong, but fair use rules around here usually limit you to quoting no more than three paragraphs.

    “Mitt Romney is the only person in America who looked at the way this Congress is behaving and said, ‘I want the brains behind THAT operation.’ ” — Tom Perriello

    by hungrycoyote on Fri Jan 03, 2014 at 10:55:12 AM PST

    •  Yikes - that calls for an HR (5+ / 0-)

      No, you re not wrong. Copyright and fair use massively abused here. even though it's published udner Creative Commons guideliens, the required attribution and link is clearly absent.

      (BTW - the "3 pragraphs" is a rough rule of thumg, often cited, but it can be more, or less, depending on the length of the original work. In this case, it should probably be less)

      “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

      by Catte Nappe on Fri Jan 03, 2014 at 11:59:14 AM PST

      [ Parent ]

      •  Sorry for my mistakes (0+ / 0-)

        Tired of living in a "RED" state... Colorado here I come!!

        by deereigna on Sat Jan 04, 2014 at 04:37:57 PM PST

        [ Parent ]

        •  Please read what I wrote below. (0+ / 0-)

          Tired of living in a "RED" state... Colorado here I come!!

          by deereigna on Sat Jan 04, 2014 at 04:38:55 PM PST

          [ Parent ]

          •  I have read it (1+ / 0-)
            Recommended by:
            VClib

            You still have failed to edit your "cut'n'paste" to fit fair use standards, or to provide the required attribution link.  This whole discussion is verging on "dead thread" territory, so you shouldn't feel compelled to go beyond the minimal changes needed to legally conform.   Next stop - some of the links for new members and diarists that others have posted. And I recommend a solid period of reading other diaries, and commenting in them, so you get comfortable with the standards and expectiations before you venture your next diary.

            “Texas is a so-called red state, but you’ve got 10 million Democrats here in Texas. And …, there are a whole lot of people here in Texas who need us, and who need us to fight for them.” President Obama

            by Catte Nappe on Sat Jan 04, 2014 at 05:49:41 PM PST

            [ Parent ]

            •  I don't know what to do... (0+ / 0-)

              Should I delete the whole diary? I don't know how to provide a link. That was why I put the name of the web site in my introduction. Also, I'm not sure how to change it...
              Do I need to rewrite in my words, or how do I do this. I tried to find the fair use standards.
              Where do I go to find more instruction?

              Tired of living in a "RED" state... Colorado here I come!!

              by deereigna on Sat Jan 04, 2014 at 07:41:17 PM PST

              [ Parent ]

  •  deerigna - Change the title (7+ / 0-)

    Thomas was the author, but the decision was unanimous. Thomas no more decided this than any other member of the SCOTUS.

    "let's talk about that"

    by VClib on Fri Jan 03, 2014 at 10:55:15 AM PST

  •  scotusblog.com is a great resource for all cases (7+ / 0-)

    before the Supreme Court, including their award winning "In Plain English" columns. Here is a link to this case.

    http://www.scotusblog.com/...

    "let's talk about that"

    by VClib on Fri Jan 03, 2014 at 11:00:51 AM PST

  •  Unanimous (6+ / 0-)

    That means that the person just didn't have the law on their side - and SCOTUS, even our liberal justices, cannot, despite rightwing talking points, rewrite the law.

  •  Misleading title aside (7+ / 0-)

    I wonder if this means that the insurance companies can prolong the appeals process so that it extends past the statute of limitations.

    Most of the people taking a hard line against us are firmly convinced that they are the last defenders of civilization... The last stronghold of mother, God, home and apple pie and they're full of shit! David Crosby, Journey Thru the Past.

    by Mike S on Fri Jan 03, 2014 at 11:06:30 AM PST

  •  Can Lawsuits Be Accepted While the Appeal (1+ / 0-)
    Recommended by:
    Leftleaner

    process is ongoing? Or would a court dismiss it out of hand?

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Fri Jan 03, 2014 at 11:16:26 AM PST

    •  If the insurance company had stalled... (2+ / 0-)
      Recommended by:
      ColoTim, Cassandra Waites

      ...until it was impossible to file a lawsuit, the appellant here may have had a case.  There was a reasonably large gap between when they could have filed and when they did file than undermined their position.

    •  The article says that (0+ / 0-)

      a lawsuit can't be filed until the appeals process is exhausted. My experience with appeals in health cases is that the appeals take months to be looked into and a denial letter sent out. An appeal for services at an IHS facility I went through took 2 years for them to decide that my ear bleeding on a Sunday, 100 miles away from my home, was not an emergency, so my bill for a hospital visit was denied, and the bill deferred to me. I returned an appeal within days of each denial, still it took 2 years to go through their process, and if I had been seeking legal help, I would have been out of luck.

      Tired of living in a "RED" state... Colorado here I come!!

      by deereigna on Sat Jan 04, 2014 at 08:07:03 PM PST

      [ Parent ]

  •  Diarist is new and needs instruction/help (0+ / 0-)

    UID: 975513
    Joined: Sep 3, 2013

    Comment history shows a mildly troubling tendency of this diarist to post comments on old, inactive diaries.  That, along with the completely false title, is worrisome.

    If this diarist weren't so new, I'd HR this diary.  Instead, I'll err on the side of giving benefit of the doubt.

    Can someone please post a link to the DK group for new diarists/help for new diarists?  I'm drawing a complete blank on it.

    They don't win until we quit fighting!

    by Eyesbright on Fri Jan 03, 2014 at 03:33:32 PM PST

    •  Yesterday, I sent the diary author a kosmail (2+ / 0-)
      Recommended by:
      Eyesbright, Catte Nappe

      asking that he/she return to the diary, change the title, and fix the fair use issues. However, no response in kosmail or in the comments. I am going to HR the tip jar.

      "let's talk about that"

      by VClib on Sat Jan 04, 2014 at 10:04:23 AM PST

      [ Parent ]

    •  Thank you for giving me the benefit of doubt. (1+ / 0-)
      Recommended by:
      Eyesbright

      Honestly, I don't get to get on the computer enough sometimes to be current. I try not to comment if I see that I'm extremely behind the rest of you. I just can't seem to keep up. The title actually came from the way the story was sent to me. It seemed as if they were saying Thomas was responsible for pushing this decision. Evidently that was wrong. I will be more careful in the future, and will only post when I have enough time to write in my own words. As I wrote at the bottom of this, it was brought to my attention, and  I thought it needed looking in to. The easiest way to do it was to just copy and paste. I thought it was better than saying nothing about it. I did try to show that the words were not mine, so I didn't think it was plagiarism. I gave credit to the source. I'm sorry if I upset everyone.

      Tired of living in a "RED" state... Colorado here I come!!

      by deereigna on Sat Jan 04, 2014 at 04:51:51 PM PST

      [ Parent ]

  •  I am so sorry (0+ / 0-)

    I didn't mean to blame it all on Thomas. I realize it was a unanimous decision, but the article called out Thomas, and I remembered there were some other things he did. I didn't mean to abandon this, I saw the article, and thought it needed to be addressed. What was passed, not who passed it. This decision leaves people appealing medical decisions for a length of time, and if the statute of limitations run out before the appeals process is over, the injured party is left with no recourse since they state that the plaintiff cannot file a lawsuit until the appeals process is exhausted. I addressed it quickly before taking my three grandchildren to stay for a couple of nights, and I'm just now getting back to my computer. I didn't know I had to stay online to answer questions or comments every time, and quite frankly, I really didn't think anyone was reading my stuff anyway. I just get so frustrated with the current mindset and decisions being made. Right now, I'm fighting a statute of limitations battle. I broke my back, and had surgery to repair it. After 2 years, I began having bad problems, and my right leg began crumbling out from under me while I was walking. After a few more years of trying to figure out what had gone wrong, I was taken back in to surgery for a laminectomy. I had excess bone growth at the level of my fusion, and bone spurs up and down my entire spine. I began asking my doctor if it had anything to do with the substance they put in my back to "promote bone growth," and got a resounding no from my doctor every time I asked. I saw other neurosurgeons, who ultimately didn't want to work on me, with one even telling me that I "need to go back to the doctor that did this to you." After a long time of questioning, and getting no answers, I saw a commercial on TV, that showed a picture of the cages I have in my back, and called it a Medtronics Infuse Bone Graft. I went back to ask the doctor about this, and why he didn't tell me about the lawsuit when I had to come in for a laminectomy. I was promptly chastised, sent out of his office, and told to never return. Upon contacting a lawyer, the first thing I was told was that since my surgery was in 2002, I was outside the statute of limitations. Then I was told that it was according to when I found out about how I had been harmed. I didn't know what the problem was until last Feb. when I saw that commercial, and began to put it together. Problem is, I can't prove that. Anything that takes away a persons ability to seek justice by keeping them in appeals until the statute runs out, just seems wrong to me. Sometimes it's hard enough to just figure out what is wrong, and who was responsible. To a lay person, it makes it almost impossible. I will change the title, but I really think the idea I was trying to convey still stands. SCOTUS screwed people with this one.

    Tired of living in a "RED" state... Colorado here I come!!

    by deereigna on Sat Jan 04, 2014 at 04:21:02 PM PST

    •  deereigna - the facts in your unfortunate (0+ / 0-)

      situation are not remotely related to the facts in this case. This case was decided based on the Employee Retirement Income Security Act (ERISA) which is a separate body of law that deals exclusively with employee benefits and is unrelated to typical medical malpractice situations. Medical malpractice laws are state statutes and can differ significantly from state to state. ERISA is a federal law and covers employees nationally.

      Unless you really know the law, it is difficult to write on legal subjects here on DKOS because we have many registered users who are lawyers.  

      "let's talk about that"

      by VClib on Sat Jan 04, 2014 at 07:52:09 PM PST

      [ Parent ]

      •  I realize my case is different (0+ / 0-)

        the idea I was connecting was that when they put arbitrary time limits on being able to file lawsuits, the situation should be considered. For example IF this person had returned timely appeals, and it took 3 years to go through their process, and they aren't allowed to file a lawsuit both, when in the appeals process, or after 2 years, it kind of leaves that person in a situation.

        Tired of living in a "RED" state... Colorado here I come!!

        by deereigna on Sat Jan 04, 2014 at 08:15:20 PM PST

        [ Parent ]

        •  That's not what the Court ruled (0+ / 0-)

          The opinion makes it clear that the plaintiffs must have a "reasonable period". In this case the plaintiff had a year to file after her final appeal had been denied by the insurance company. The fault was really with her lawyer.  

          "let's talk about that"

          by VClib on Sat Jan 04, 2014 at 08:27:59 PM PST

          [ Parent ]

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