The 6th Circuit recently granted a request for en banc review of the Rochow v Life Insurance of North America case where a three judge panel determined that the claimant could recover for unjust enrichment the profits the insurance company had earned on the wrongfully denied LTD benefits.
As most ERISA practitioners recognize this case could be a significant positive development for many ERISA claimants as it would provide a significant additional incentive for LTD insurance companies to review claims fairly. By forcing an insurer to disgorge the profits it has earned from the retention of wrongfully denied benefits instead of just paying the benefits that should have been paid in the first place, the Court has potentially removed ERISA’s inherent incentive for disability insurer’s to deny otherwise meritorious claims with impugnity.
Plaintiff’s will however have to wait for the en banc decision of the circuit court as:
“The effect of the granting of a hearing en banc shall be to vacate the previous opinion and judgment of this court, to stay the mandate and to restore the case on the docket sheet as a pending appeal.”