Fortier v. Hartford Life & Accident Insurance Co., No. 18-1752 (1st Cir. 2019)Annotate this Case
In this Employee Retirement Income Security Act (ERISA) suit, the First Circuit affirmed the district court's judgment finding that Plaintiff’s appeal from the expiration of her long-term disability (LTD) benefits was untimely and granting a motion for judgment on the administrative record for the disability insurer and the plan under which Plaintiff received the benefits, holding that the district court did not err.
After Hartford Life and Accident Insurance Company (Hartford) gave notice to Plaintiff that the LTD benefits it had provided her under the Dartmouth Hitchcock Clinic Company Long Term Disability Plan (Plan) would expire, Plaintiff filed an untimely appeal. Plaintiff then brought this action arguing that even if the appeal was untimely, the untimeliness should be excused. The district court granted a motion for judgment on the administrative record for Hartford and the Plan. The First Circuit affirmed, holding (1) the ERISA regulation defining an “adverse benefit determination” requires that the 180-day time limit start from the date of notice of termination of benefits; (2) Hartford properly followed the terms of the Plan, which met the ERISA requirements; (3) the ERISA substantial compliance doctrine did not excuse Plaintiff’s untimely ERISA administrative appeal; and (4) the New Hampshire notice-prejudice rule did not apply to Plaintiff’s situation.