The Employee Retirement Income Security Act (ERISA) does not prescribe a statute of limitations applicable to lawsuits to recover benefits. Generally, the analogous state statute of limitations applies. However, a benefit plan may impose a different statute of limitations within the terms of the plan provided that the period is reasonable.
In Mirza v. Insurance Administrator of America, Inc. No. 13-3535 August 26, 2015, the Third Circuit Court of Appeals held that the notice of a denial of a benefit must include information about the time limits applicable to both the plan appeal procedures and the claimant’s right to bring a civil action in court. The limitations period provision was buried on page 73 of Insurance Administrator of America’s 91 page governing plan document.
To reach its conclusion, the Court interpreted the text of the Department of Labor’s regulations governing claim procedures, 29 C.F.R. §2560.503-(g)(1)(iv). To comply with the regulations, a notice of benefit determination must provide a “description of the plan’s review procedures and the time limits applicable to such procedures, including a statement of the claimant’s right to bring a civil action under section 502(a) of the Act [ERISA] following an adverse benefit determination on review.” “Including” encompasses the time limits to bring a civil action as well as the time limits to file a plan appeal. Plan administrators have a light burden, “trivial” in the words of the Court, to inform claimants of deadlines for judicial review in the adverse benefit determination.