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This is ERISA. This is Us.

Welcome to the first blog post from the ERISA attorneys at Essex Richards.

We’re new to this blogging thing. That will probably be obvious. But hopefully it will also be obvious that we’re not new to ERISA. It’s kind of our thing.

Our goal is to provide useful information for our current and future clients, as well as to their critical support networks of friends, family, and doctors. We also want to give ideas and information to other employees, participants, beneficiaries, and others that just need some help. We’ll cover issues that arise in the different kinds of cases that fall under ERISA: long-term disability, medical claims and health benefit denials, pension/retirement issues, life insurance, accidental death and dismemberment, breach of fiduciary duty, and more.

While we’ll talk about developments and strategies in ERISA and employee benefits issues generally, our home and our focus is North Carolina. ERISA is governed by federal statutes and regulations, and court opinions from all across the country are relevant, but we always look at this body of law through a North Carolina lens. North Carolina is where we live, work, play, and practice. It’s what we know.

So just what is the current state of ERISA law in North Carolina? Glad you asked. Because ERISA is a federal statute, the federal courts have original jurisdiction, which means that virtually all ERISA cases are litigated in our state’s three United States District Courts – the Western (WDNC), Middle (MDNC), and Eastern (EDNC) districts. We actively practice in all three.

Federal courts use an electronic system for filing all civil cases, and the filings are available to the public through the court’s PACER system. Using PACER, we were able to look at all of the ERISA cases filed in North Carolina’s three federal districts over the past 5 years. Here’s what we learned:

  • Based on the data we reviewed, close to 300 relevant ERISA benefit cases were filed.
  • About 75% of all the cases filed were settled between the parties.
  • Of the remaining cases that were decided by the court, plaintiffs won 13.
  • Our firm’s clients won 8 of those 13 cases.
  • Unfortunately, our research also shows that, more often than not, plaintiffs are not successful when their case is decided by the court. Of cases that were decided by the court, 19 were won by the defendant companies. This means that insurance companies and plan administrators are winning substantially more than half of the cases decided by the courts. This appears to be the trend, nationwide, as well. Why is the outcome so lopsided? We will elaborate more in a later blog, but we believe the biggest reason is that ERISA gives insurance companies and plan administrators a huge advantage. In most cases, a claimant must show that the defendant company abused its discretion in denying or terminating benefits. This is much more difficult than the routine civil case where a judge can look at the evidence impartially and decide whether the evidence tips in favor of one side or another.
  • During this five-year period, North Carolina ERISA plaintiffs won 3 cases in the Fourth Circuit Court of Appeals, the court just below the United States Supreme Court. Our firm won all three of those cases.

Going forward, we’ll delve deeper into some of these cases and trends, and explain just why it is we think North Carolina is such a fertile ground for continuing to develop and improve the state of ERISA and employee benefit law. We have a dedicated legal bar, an engaged judiciary, and steadily evolving legal precedent that we are proud to have had a hand in developing. We’re excited about what North Carolina can bring to the national ERISA conversation.

So that’s us. We hope you’ll continue to read our ERISA blog. We’ll try our best to make it informative and interesting, and to keep it regularly updated. We invite you to submit questions, comments, (veiled) criticisms, and even suggestions for future topics here.

Disclaimer: We are ERISA attorneys, but we are not your attorneys and this article does not create an attorney-client relationship. The information in this blog post is provided for general information purposes only, and may not reflect the current law in your jurisdiction. No information in this blog post should be construed or seen as legal advice, nor is it intended to be a substitute for legal counsel on any subject matter.