1.02.2007

First Circuit Notes Split on an Array of ERISA Issues

Per Bard v. Boston Shipping Ass'n, --- F.3d ----, 2006 WL 3717376 (1st Cir. Dec. 19, 2006):

Our consistent approach in ERISA cases has been to eschew automatic rules and to evaluate each case on its own. See, e.g., Buffonge v. Prudential Ins. Co. of Am., 426 F.3d 20, 31 (1st Cir.2005) (taking a case-by-case approach to determining the proper ERISA remedy); Glista v. Unum Life Ins. Co. of Am., 378 F.3d 113, 130-31 (1st Cir.2004) (taking a case-by-case approach to addressing a plan's attempt to articulate in litigation a new basis for the denial of benefits).

Here, it is easy to understand why a multi-employer pension plan, whose trustees are equally divided between labor and management, would not be as efficient as a single decision-maker. At the same time, it is not clear that the ERISA regulatory structure intends to give multi-employer plans the kind of slack that the Plan appropriated for itself in this case. Cf. 29 C.F.R. ยง 2560.503-1(i)(3)(ii) (outlining special time limits, applicable only to multi-employer plans, for a plan to decide a disability benefits appeal and notify the claimant).

Ultimately, we do not decide whether the Plan's failure to render a timely decision by itself entitles Bard to de novo review, whether the Plan's eventual benefits denial after suit was filed was in "substantial compliance" with ERISA's time limits and other regulations, or whether inquiry into "substantial compliance" is even relevant in ERISA cases of this nature--whether brought under the new regulations or otherwise. Those are complicated questions on which the circuits have divided. See Nichols v. Prudential Ins. Co. of Am., 406 F.3d 98, 106-10 (2d Cir.2005) (discussing the different positions taken). Instead, in keeping with our case-by-case approach, we tailor our resolution of the issues to the unique facts presented.

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