Employers Accused of Using Federal ERISA Law to Deny Benefits

By | July 7, 2008

  • July 7, 2008 at 7:29 am
    Incredible says:
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    Those people arguing over a free ride should look up the facts of the court filing. Mr. Amschwand actually worked for Spherion, for more than a day, but took a leave from the company upon his diagnosis. While still employed, but on leave from the company, he was diagnosed with cancer. Spherion’s subsequent change in policyholder’s should not have made any difference to the ultimate policyholder. Spherion’s aceptance of Mr. Amschwand’s payments towards his life insurance policy while he was on documented leave for his illness only further demonstrate Spherion’s culpability.

    Mr. Amschwand’s failure to secure a second party term life insurance policy is irrelevant. It is unfortunate Mr. Amschwand could not prove, in court, Spherion purposely mislead him through their communications to the Amschwand family. I agree the unanswered requests for a copy of his policy should have been a red flag, but the companies failure to provide said policy should also only further the Amschwand’s case. These people weren’t looking for a hand-out, only what they were legally entitled to.

  • July 7, 2008 at 10:24 am
    Retta says:
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    I have read the previous comments, and just wanted to interject. I am over 50 and my husband is diabetic. We have inquired for life insurance outside of our employer plan. It is impossible for us to pay the premiums. So sad that most people when they are young and healthy don’t think of such things.

  • July 7, 2008 at 11:12 am
    Hal says:
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    This brings to mind Marx’s description of the French finance aristocracy before the revolution of 1848, in which “the mania to get rich was repeated in every sphere… to get rich not by production, but by pocketing the already available wealth of others.”

    Marx wrote: “Clashing every moment with the bourgeois laws themselves, an unbridled assertion of unhealthy and dissolute appetites manifested itself, particularly at the top of bourgeois society—lusts wherein wealth derived from gambling naturally seeks its satisfaction, where pleasure becomes debauched, where money, filth and blood commingle.”

    Corporate corruption, $45MM severence packages for CEOs stepping down in failure, poor widows denied death benefits, no justice for the weak. The time is ripe for “Meaningful Change”. Carl would be proud of just how far we’ve sunk.

    And so it goes…

  • July 7, 2008 at 12:51 pm
    Leslie says:
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    People who are outraged about these types of corporate behavior should take action…starting with moving your investments out of Schwab accounts.

  • July 7, 2008 at 1:01 am
    Thom says:
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    Spoken like a true commie !

  • July 7, 2008 at 1:03 am
    Agent says:
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    Why not start by buying a real policy from a real company and a real insurance agent. TERM INSURANCE COSTS HOWMUCH??

    Here we go let’s start blaming the pay packages of CEO’s. Why not live by the phrase “DON’T Put all you eggs into one (your Companies) BASKET” Diversify, get a CHEAP!!! TERM POLICY OUTSIDE OF WORK!! It cost’s what per month for TERM INSURANCE, less than 50.00 per month Lets see shall I get the 24″ new Rims and rent them or buy life insurance. Hmmmmmmmm!?

    When they never produced the policy should have been a red flag, but who knows may have been already diagnosed.

    Sure rings home the phrase “Life Insurance is for those who die, not those who live”. But we all know someone who doesnot have it or enough of it.
    Agent

  • July 7, 2008 at 1:25 am
    Hal says:
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    Thom,

    LOL. I am neither a progressive liberal nor do I espouse the teachings of Carl Marx. However, Marx’s take on the consequence of greed in a Capitalist economy seems to ring true. How you can so easily dismiss that reality is somewhat troubling, as it will take an informed consumer to institute change in the market place or, as a last resort, an engaged constituency to force legislative reforms.

  • July 7, 2008 at 1:29 am
    Bob says:
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    The Goeres’ story is night and day different than the Amschwand one. If the Schwabb retirement account had gained $500,000 do you think there would have been a lawsuit (and who didn’t loose lots of money during this period of the dot com collapse)? On its face Amschwand is a terrible situation but if there were no limit to the employer’s liability for benefits many medium to small companies would drop them completely – and then you’d have to buy from AFLAC (which, by the way, is a good thing). “Agent” is correct in the advice to buy outside your companies offerings – Agents carry E&O to protect the Amschwands of America

  • July 7, 2008 at 2:14 am
    What? says:
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    Many people cannot buy any life insurance other than through an employer group. One has to have good (perfect) health to purchase a policy. Someone with cancer is not going to be able to buy any other life or health insurance.
    Your an agent. Do you not know that? Remember adverse selection.

  • July 7, 2008 at 2:20 am
    What? says:
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    Sorry, I meant to write you’re, not the incorrect your.

  • July 7, 2008 at 2:28 am
    media mogul says:
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    Just like Karl Rove.

    When Karl’s writings become so on target and relvant, we know we are in deep trouble–either one of them’s writings.

    Sigh….

  • July 7, 2008 at 2:38 am
    Agent says:
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    BASED on your implied assumption you are correct Einstein!!! HOWEVER, the article didn’t say that. Since when is it a companies duty to cover pre-existing conditions if he did have cancer prior to obtaining his job there? Did He have cancer prior to starting the job? Does not say. If he was married how come he didn’t have a life policy upon getting married? I KNOW, I KNOW, it could happen to me syndrome!!!!! Didn’t ENRON teach you anything, sure there are unethical bus. owners but are all companies like them? I don’t think so.

    I’m still trying to figure out why it’s the companies fault that the CEO’s who supposidly make all the money/perk’s are too blame? That’s the intent of the BLOG. Always a company’s fault. KEEP LOOKING FOR YOUR GOV’T to bail you out. Your entitlement mentality will continue to put this great country in peril.

    “YOU ARE OWED NOTHING IN LIFE”. If it’s so dam easy then why do you start your own company and then you’ll get all the perks. Your wife can kiss you as you go out the door and say “HAVE A NICE DAY AT THE CAKEWALK, HONEY!!!”. Learn about benefits, cash flow and making payroll. Then come read me a poem, but not before.
    I’ve got family with cancer, I’ve got family whose husband died w/out enough life insurance but they said it couldn’t happen to them. Spare me the song and boo hoo!!!!! This why mommy said life is not fair!!!!

  • July 7, 2008 at 2:54 am
    Hal says:
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    LOL – that proves my point about not being a commie. How could I ever overlook that misspelling? Thanks for the correction there Mogulsan. As for Karl Rove, and the rest of these One Worlders, that bolt of cloth just keeps them coming.

  • July 8, 2008 at 9:07 am
    Agent says:
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    Your response is warrented, almost sounds Lawyer “ish”. Here’s what you forgot to mention. As a agent, and yes Life Insurance is one of the products, EVERYONE CLIENT KNOWS that if you have “GROUP LIFE(employer plan Life Ins.)” it(Group Life) WILL NOT PAY IF YOU GO ON DISABILITY CLAIM. Therefore, if you have group life and you go on disability claim, and your company is paying you disability, the group life policy will not pay, period. I beg you to go ask your H.R. person. THERE is NO COMPANY IN THE USA that will pay a death claim if the party is on disability through the GROUP PLAN. NO COMPANY!!!! Again ask your H.R. person this, I beg my clients to ask, the one’s that do ask find out real quick how good that GROUP LIFE POLICY IS. Yes it’s the cheapest, but something tells me “YOU ALWAYS GET WHAT YOU PAID FOR”.

  • July 8, 2008 at 10:47 am
    Joe says:
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    Agent, your ignorance regarding the issue at hand is nothing less than entertaining. This is not a debate about what type of coverage would have been more beneficial for the Amschwands, but rather the error on Spherion’s end of not fully disclosing the terms of the insurer change, and what would be required for coverage to continue. They did not deny coverage because he was on disability, but rather, that he did not meet the work requirements for coverage to be in effect. Not sure what the laws are in your state, but any material change in insurance coverage or conditions of coverage that affect a policyholder must be made aware to the policyholder in writing. In addition, the fact that Spherion had waived the “one day of work” requirement for other employees, but not for an employee that was likely going to die of cancer in the near future, makes this case stink of corporate greed just a little bit more.

  • July 8, 2008 at 1:53 am
    agent says:
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    Shall I now bow down and recognize you holyness? My ignorence? Corporate GREED?
    WHO’s your pay check coming from. WHAT CORPORATE RAIDER/Crook company do you work for? An EVIL OIL COMPANY, or EVIL INSURANCE COMPANY. Oh you are a lawyer, FIGURES!!! Oh own your own company? How long have you been opporating ETHICAL?????
    Based on your premise you all are all crooks.
    FORGIVE ME OH GREAT ONE, OH LORD
    DARTH VADER. NOW GO HUG YOUR BONGO.

  • July 8, 2008 at 3:50 am
    Joan M Wetherell says:
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    This is a typical sneaky insurance company tactic, and there should be something in Federal law that requires notification of a change in terms or of requirements. Re: the “ASSumed” comment: it is grossly unfair to people who have done everything they knew to do to comply; and have been told by their benefits department that they have done everything (i.e., lied to). There is no way to anticipate all the possible requirements/barriers a company can put on benefits.

  • July 14, 2008 at 9:57 am
    ad says:
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    Agent, thanks for the info. I will get my contracts from my employer and read them. Hate to say it, but it is OUR fault if we do not take the time to read the contracts, NOT THE BIG RICH CORPORATION. I’m as guilty as the next guy in not making the time to read the paperwork, and I do know better.

  • July 14, 2008 at 10:08 am
    Timothy George says:
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    Reading such stories such as this clearly shows the need for legal clarification on ERISA by the supreme court along with restitution to the beneficiary. The company clearly was wrong as was their insurance company. Shame onboth of them.

  • July 14, 2008 at 3:49 am
    Kay says:
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    Agent – this is very interesting news – “GROUP LIFE(employer plan Life Ins.) it(Group Life) WILL NOT PAY IF YOU GO ON DISABILITY CLAIM.”

    I’ve been on hold with my plan administrator (parent company) for 45 minutes; they can’t say whether you are correct or now…. which now has me nervous!

    Guess it’s time for me (at 32) to shop for some outside life insurance.

    I’m taking this to mean, for example, if I’m out on disability (be it short or long) for, say, cancer treatment, and die, that my beneficiaries will not receive my life insurance?!?!?! shocking and very concerning if correct…

  • July 14, 2008 at 3:54 am
    Kay says:
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    The below post was meant for you too.

    However, I just got off the phone with my plan administrator who states that when we are on STD, all benefits stay in force as if we were an active employee.

    On LTD, life insurance, health insurance and disability insurance stays in force and is collectable.

  • July 14, 2008 at 4:01 am
    Ken says:
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    As I recall, when changing plans or carriers, an employer always has to be sure they are addressing all existing situations, temporarily disabled, etc. In this case, that was overlooked.

  • July 16, 2008 at 11:10 am
    Waterbury says:
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    I find it incredible that judges cannot “judge” in favor of the spirit of the law! Liberty Mutual denied me of LT disability even after ten back surgeries. All they had to do was show they followed a process to come to a conclusion. I sent my case with critical comments for changes in the law to Hillary Clinton, my Senator, and received back a bunch of rhetoric and do nothing. ‘But she soundly supports the disabled.’ Insurance companies should be criminally held responsible for what they did to me during the process of obtaining LTD. They used the system to their advantage by postponing medical approvals to make the dates extend beyond my legal reach. They back dated letters, sent them to wrong addresss (all at their admision), and harrassed me with endless forms. The final date for appeal was one day before my last test stating I had five severely degenerated disk’s and two moderate. One day!!!

  • July 18, 2008 at 8:48 am
    Waterbury says:
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    I wrote a comment on ERISA/ Disability. The same case the CEO of Liberty Mutual sat on the board of Bank of America overseeing first corporate compensation then Human Resourses. That year he voted to give the CEO of BOFA $220 million in stock on top of his salary. In return the CEO of BOFA started using Liberty Mutual to handle their ERISA and W/C benefits as well as purchasing LM’s financial arm and making employees use it as their 401K. CORPORATE CORUPTION.

  • August 7, 2008 at 4:36 am
    Miles says:
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    Bob, you’re wrong. (“If the Schwab retirement account had gained $500,000 do you think there would have been a lawsuit?”)

    Of course not, because if the value of the account had gone UP there would’ve been no loss.

    >”(…and who didn’t lose lots of money during this period of the dot com collapse)?”

    If Schwab had acknowledged Goeres as the beneficiary in the first place instead of dragging their feet for 16 months, THERE WOULD’VE BEEN NO LOSS. Goeres would’ve been able to sell the stock and get out of the market before it sank another 500 grand.

    As for Amschwand, you say “if there were no limit to the employer’s liability for benefits many medium to small companies would drop them completely.” But you’ve got it all wrong. Who said anything about no limit to the employer’s liability? Melissa Amschwand isn’t suing for unlimited damages, she’s suing for the face amount of the life insurance policy — the insurance policy that her husband EARNED by working for Spherion and contributing premiums.

    This case truly is an outrage.

  • August 7, 2008 at 4:48 am
    Miles says:
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    Jeez, Agent, take a chill pill. Nobody is saying Sperion HAD to provide life insurance to their employees. But they chose to, as part of their benefits package to encourage people to work for that company. It’s a contract. And once both parties agree to the contract, both parties are bound by it. If Spherion chooses to offer life insurance, and the employee takes advantange of it and pays premiums, then he is entitled to the benefits of that contract.



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