United States: U.S. Supreme Court Holds That ERISA Plan Can Enforce Contractual Limitations Provision To Bar Benefit Claim Lawsuit

The U.S. Supreme Court in Heimeshoff v. Hartford Life & Accident Insurance Co. et al. resolved a split among the circuits when it held that a contractual limitations clause in an ERISA-governed long-term disability benefits plan is enforceable even where it causes the limitations period on a claim for benefits to commence before the participant's cause of action accrues.  In this case, the plan-based limitations period in which to file a disability claim lawsuit under ERISA Section 502(a)(1)(B) started to run when "proof of loss" was due under the plan, even though the participant's cause of action did not accrue, and a lawsuit could not be filed, until the plan's internal claim review process had been exhausted. Citing ERISA's important policy of enforcing plan terms as written, the Court held that the clause was enforceable.

The Legal Framework

ERISA Section 502(a)(1)(B) allows a participant or beneficiary to commence an action "to recover benefits due to him under the terms of his plan, to enforce his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan."1 As the statute suggests, and the Heimeshoff Court recognized,2 claims for benefits are "bound up" with the terms of the governing plan document, which must be enforced as written. 

ERISA does not codify a statute of limitations for actions to recover benefits.  Courts have, therefore, looked to analogous state law for the length of the applicable limitations period.  When determining the point at which the limitations period commences, courts have applied the federal discovery rule, and held that the limitations period starts "when there has been a repudiation by the fiduciary that is clear and made known to the beneficiary."3 Typically, this is triggered when appeals of denial of benefits are completed.  Under the "clear repudiation" rule, however, the limitations period may begin to run earlier, even before the plaintiff has applied for benefits.

Prior to Heimeshoff, federal courts enforced "reasonable" contractual provisions in plan documents shortening the limitations period for benefit claims from what the most analogous state law would have provided.  The key issue raised by Heimeshoff was whether such a contractual provision could also cause the limitations period to start before the claimant had exhausted the plan's internal claim review procedure.  Because plaintiffs must exhaust a plan's administrative remedies before filing a court action to recover benefits, enforcing contractual provisions such as the one in Heimeshoff results in a limitations period starting to run before the plaintiff's cause of action accrues, rather than after receipt of a final decision on the claim.        

Factual Background

The plaintiff stopped working on June 8, 2005 due to her alleged diagnosis of lupus and fibromyalgia, and symptoms of extreme fatigue, pain and lack of concentration.  On August 22, 2005, she filed a claim with Hartford Life and Accident Insurance (Hartford), the plan's administrator for long-term disability benefits.  When the plaintiff's treating physician failed to supply additional information in response to Hartford's requests, Hartford denied the claim, subject to re-opening it if the plaintiff came forward with the requested information.  In July and October 2006, the plaintiff submitted additional medical evidence in support of her claim.  Hartford denied the claim in November 2006, finding that plaintiff was able to perform her sedentary job functions.

In May 2007, the plaintiff requested an extension of the appeal deadline and submitted her appeal to Hartford with other medical documentation on September 26, 2007.  That appeal was finally denied on November 26, 2007.

On November 18, 2010, the plaintiff filed suit, seeking review of her denied claim for disability benefits under ERISA Section 502(a)(1)(B).  The defendants moved to dismiss the claim on the grounds that it was time-barred under the plan's contractual limitations clause, which stated:  "Legal action cannot be taken against The Hartford . . .  [more than] 3 years after the time written proof of loss is required to be furnished according to the terms of the policy."4 If the three-year limitations period were counted from when Hartford issued its final denial on November 26, 2007, the plaintiff's claim would have been timely.    

Procedural History

The district court granted the administrator's motion to dismiss, finding the claim to be untimely under the plan's clear limitations period.  On appeal, the U.S. Court of Appeals for the Second Circuit affirmed, finding that "it did not offend ERISA for the limitations period to commence before the plaintiff could file suit under Section 502(a)(1)(B)."5

The U.S. Supreme Court agreed to resolve a circuit split on the following question: "When should a statute of limitations accrue for judicial review of an ERISA disability adverse benefit determination?"

The Decision

On December 16, 2013, Justice Thomas delivered a unanimous opinion holding the provision in question to be enforceable, starting the limitations period before the plaintiff had fully exhausted her administrative remedies and received a final claim denial.  In so ruling, the Court emphasized the importance of enforcing the written terms of an ERISA plan, citing its several recent decisions endorsing this rule.   

The Court acknowledged that, in its prior decisions, it had often construed statutes of limitations to commence no earlier than when the plaintiff was permitted to file suit – but only when dealing with a statutory statute of limitations, not a contractual limitations period.  It recognized, however, that "statutes of limitations do not inexorably commence upon accrual."6 Additionally, in the case before it, "the parties [had] agreed by contract to commence the limitations at a particular time."7 Relying on Order of United Commercial Travelers of America v. Wolfe, 331 U.S. 586, 608 (1947), the Court concluded that such a clause is enforceable.  Wolfe allows parties to a contract to choose a shorter limitations period than would otherwise apply under a general statute of limitations, provided the limitations period is reasonable and there is no controlling statute to the contrary.  The Court in Heimeshoff held that "[t]he Wolfe rule necessarily allows parties to agree not only to the length of a limitations period but also to its commencement."8

The Court held that the clause in the Hartford policy met both conditions of the Wolfe rule.  Because the three-year clause at issue in the Heimeshoff case allowed claimants ample time to bring suit following conclusion of a plan's internal review process (which lasts, in most cases, "about one year"), the Court found it was reasonable.

The Court held also that there was no "controlling statute" contravening the clause.  The Court rejected the plaintiff's argument that contractual clauses such as the one at issue will undermine ERISA's two-tiered remedial scheme, whereby exhaustion of administrative remedies precedes a federal court action.  Participants will still be incentivized to employ plans' internal review mechanisms, the Court opined, in order to develop an evidentiary record in anticipation of judicial review.  And such clauses will not "endanger judicial review" of benefit claim denials, the Court reasoned, because ERISA regulations governing claim review procedures contain safeguards that would protect claimants from purposeful delays in claims decision-making.  The Court noted that "the vast majority of states require certain insurance policies to include 3-year limitations periods that run from the date proof of loss is due[,]" yet there was little evidence that such provisions had "thwarted judicial review."9 Finally, according to the decision, courts can also apply equitable doctrines, e.g., tolling, in the "rare cases" where participants demonstrate extraordinary circumstances in the internal review process that precluded them from timely filing legal action.10

The Court easily rejected the plaintiff's contention that the limitations period should be tolled during the course of the internal review process, stating that the ERISA regulations require tolling of any statute of limitations only during any voluntary levels of appeal (in group health plans), but do not otherwise address plan-based statutes of limitations. 

The Court left unanswered the question of when the statute of limitations will begin to run when benefits are terminated years after an initial "proof of loss" is required.  While many employee benefits call for a one-time claim decision, others, like the disability benefits at issue in this case, require ongoing administration and may be terminated after years of payments if the participant is no longer eligible.  Courts may find that a limitations period based upon "proof of loss" is inapplicable by its own terms if the language does not apply to the circumstances under which benefits were denied.  Plan sponsors should, therefore, take care to ensure that a contractual limitations period applies in all situations that can be reasonably anticipated. 


In light of Heimeshoff, employers will want to examine their existing contractual limitations provisions in their plan documents or to consider inclusion of such a provision in the first instance.  Although Heimeshoff arose in the context of a disability plan, the decision does not appear limited to that context.  Contractual limitations provisions are particularly valuable to shorten limitations periods in states where the period would otherwise be lengthy.  By allowing plans to specify when the limitations period commences, Heimeshoff can be read to allow that period to be shortened even further (provided the period is reasonable) through the selection of events or dates that precede claim exhaustion.  As noted above, selecting the trigger date for commencement of the limitations period and ensuring that the provision can be applied to any denial of benefit situation must be done carefully.    


1 29 U.S.C. § 1132(a)(1)(B).

2 Heimeshoff v. Hartford Life Accident Ins. Co., No. 12–729, slip op. at 8 (U.S. Dec. 16, 2013).

3 Carey v. Int'l Bhd. of Elec. Workers Local 373 Pension Plan, 201 F.3d 44, 47 (2d Cir. 1999).

4 Heimeshoff, slip op. at 3 (brackets in original).

5 Id. at 4.

6 Id. at 6.

7 Id.

8 Id. at 7.

9 Id. at 12-13.

10 Id. at 14-15.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Similar Articles
Relevancy Powered by MondaqAI
In association with
Related Topics
Similar Articles
Relevancy Powered by MondaqAI
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions