Governmental Audits, Handling of Benefit Claims and ERISA Litigation

Careful front-end planning and thoughtful administration can lead to favorable results in governmental audits, benefits claim appeals and, if necessary, litigation. But even with careful planning, unavoidable controversies may arise. In such cases, the guidance of an experienced representative can make the difference in achieving a favorable outcome.

Our group frequently assists clients in preparing for Department of Labor (DOL) and Internal Revenue Service (IRS) audits. We assist clients in developing careful responses to benefit claims where a denial is likely to be challenged, thus creating an administrative record that will best withstand judicial review. The group also has experience successfully defending individuals and entities in civil and criminal Employee Retirement Income Security Act (ERISA) matters, as well as acting as an expert witness in such matters. 

  • Representation of a multiple-employer welfare arrangement in a Department of Labor audit resulting in a no-change letter
  • Preparation of claim denial letters in complex defined benefit plans requiring a detailed analysis of plan terms and transitions through numerous merger and spin-off transactions
  • Representation of numerous clients defending claims for benefits, including long-term disability benefits, life insurance benefits and pension benefits
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Recent published cases include the following:

  • Waldshan v. Stratford Consulting Group, 1:07- cv - 4865 (E.D.N.Y. 2007), in which we litigated a benefit denial on behalf of a sole participant in a defined benefit pension plan, ultimately settling the case on favorable terms
  • Sadowski v. Chock Full O'Nuts Corp., (D.C.N.J. 2006) (MCA), which we won on a motion that exhausting administrative remedies would be futile in litigation of benefit denials on behalf of U.S. Bank, as trustee of the Chock full O’Nuts Corporation Benefits Protection Trust for former employees of the company who were denied enhanced pension benefits following the hostile takeover by Sara Lee Corp; the case was settled favorably for former employees
  • Elie G. Ghattas Trust v. UNUMProvident Life Insurance, et al., 2004 U.S. Dist. LEXIS 26753; (E.D. Va. 2004), in which we won summary judgment in litigation of fiduciary breach claims against Equant defendants in its administration of a company-sponsored life insurance plan