Sedgwick Healthcare Attorneys Obtain Federal Court Win That Counters Precedent
Sedgwick Healthcare partner Michael H. Bernstein and associate John T. Seybert obtained a groundbreaking defense verdict in a federal case that parts with other federal precedent to uphold the explicit terms of a benefits plan’s limitations period.
Plaintiff filed an ERISA suit in the U.S. District Court for the Southern District of New York to challenge denial of long-term disability benefits by our clients, an insurance carrier and a long-term disability plan. Sedgwick asserted that plaintiff’s claim was time-barred due to her policy’s limitation provision. Plaintiff countered that the policy’s contractual limitations clause was unenforceable as a matter of law.
In a summary trial on the stipulated administrative record, Sedgwick argued that U.S. Court of Appeals and Southern District decisions contrary to our clients’ position failed to consider that New York insurance law expressly prescribes trigger dates for commencement of a policy limitations period. We asserted that, in light of such law, a court may not act as a super-legislature to override the statute unless it finds the law unconstitutional. Finally, we distinguished prior decisions on grounds that they involved labor laws no longer relevant to the new regulations.
Departing from precedent to find for Sedgwick’s clients, the judge agreed that a court may not override the clear pronouncements of the legislature and that deference must be “generally afforded (to) written contractual obligations.”
This decision will find application not only in the Southern District of New York but in all other jurisdictions where materially similar state laws apply.
The case is Burke v. PriceWaterHouseCoopers LLP Long Term Disability Plan, ___ F.Supp.2d ___, 2008 WL 540302 (S.D.N.Y. 2008).