Thurber v. Aetna Life Ins. Co.

A new decision from the Second Circuit that reinforces the challenges a plaintiff must overcome in an ERISA LTD benefits case. Here, not only did the Circuit court find that an arbitrary and capricious standard applied to Aetna’s conduct but it also overturned the district court’s denial of summary judgment on Aetna’s claim for an overpayment. Plaintiffs in ERISA cases often fact the overpayment issue because the insurer can take credit for amounts received from social security.

Plaintiff appealed from the district court’s grant of Aetna’s motion for summary judgment on the issue of whether the insurer improperly denied plaintiff long-term disability benefits under the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq. Because Aetna’s reservation of discretion was sufficient to compel use of the arbitrary and capricious standard of review, the court affirmed summary judgment to Aetna on its denial of benefits. The court also held that Aetna’s action seeking return of overpaid benefits was properly brought under 29 U.S.C. 1132(a)(3) as an equitable counterclaim. Accordingly, the court reversed the district court’s denial of summary judgment on the counterclaim.

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