Heimseshoff v. Hartford Life & Accident Insurance Co. and Wal-Mart Stores, Inc. (Case No. 12-729) involves the question of when a statute of limitations should accrue under ERISA for judicial review of an adverse disability benefit determination. In this case, the plaintiff brought suit to obtain long-term disability benefits to which she was entitled under the employee benefit plan. The lower courts, however, dismissed her cases time-barred by the three-year statute of limitations period set out in the benefit plan policy. If the Court were to adopt Hartford’s reading, the plan’s statute of limitation for judicial review of such adverse determinations would run before the employee even knew that his or her claim had accrued.
NELA and AARP’s amici brief argues that despite the Court’s decision last term in U.S. Airways v. McCutcheon, 569 U. S. ____ (2013), holding that clear plan terms are enforceable, here an implied term must be read into the long-term disability ERISA plan at issue in order to make the plan term surrounding the limitations period workable. In particular, amici urge the Court to allow for equitable tolling of the contractual limitations period during the time a claimant is unable to bring suit because of mandatory claims exhaustion. Such a tolling provision would provide a bright line test, is fair to all parties, and facilitates ERISA’s goal of providing a thoughtful, full, fair and frank exchange of information and a complete dialogue between them.
Authors: Mary Ellen Signorille (AARP Foundation Litigation), Ronald Dean (Ronald Dean ALC), and Nina Wasow (Lewis Feinberg Lee Renaker & Jackson P.C.).