New Jersey insurance regulators have outlawed discretionary clauses in ERISA plans that give insurers the right to interpret a policy and to determine if a claimant qualifies for life, health or disability benefits. Courts will now be able to conduct de novo hearings when a carrier denies benefits. The new state Department of Banking and Insurance rule requires carriers to note that any initial interpretation they make about policy terms may be reversed by a court or through other means.
June 06, 2007 at 12:00 AM
1 minute read
The original version of this story was published on Law.Com
New Jersey insurance regulators have outlawed clauses in ERISA plans that give insurers the right to interpret a policy and to determine if a claimant qualifies for life, health or disability benefits.
Freed of such discretionary clauses, which had been standard in many policies, courts will be free to conduct de novo hearings when a carrier denies benefits.
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