Hartford Life & Accident Insurance Co. convinced the First Circuit that neither state law nor ERISA excused a doctor’s late-filed administrative appeal.
New Hampshire’s “notice-prejudice” rule—which makes it harder for insurers to deny late-filed claims—doesn’t apply to benefit claims under the Employee Retirement Income Security Act, the U.S. Court of Appeals for the First Circuit held Feb. 20. The court followed decisions of the Seventh and Ninth circuits, adding that “no federal court has applied any state’s common law notice-prejudice rule” to a late-filed appeal made to an ERISA plan.
The doctor also cited ERISA’s substantial compliance doctrine—which excuses an ...
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