First Circuit Clarifies What a “Full and Fair Review” Means to a Denied ERISA Disability Claim

The Employee Retirement Income Security Act, which governs employer sponsored benefits like disability insurance, is not friendly to the very people it is designed to benefit – you! However, one of the saving graces in ERISA are the ERISA claim regulations which require that a denied policy holder or plan beneficiary be given a “full and fair review” during the claim review process.   Let me tell you a typical story so you understand the games the disability plans or carriers play. Ms. Jette was a legal assistant who had back problems for which she underwent back surgery.   Jette was paid short and...

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