Michael Adams Looks at “Meaningful Dialogue” Standard for Communicating a Denial of Benefits

Hinshaw partner Michael Adams authored an article featured in the March issue of the DRI’s For The Defense Magazine, in which he examines the fiduciary duty of an employee benefit plan or its administrator to communicate a denial of benefits consistent with ERISA’s requirements.

Michael notes that courts are increasingly overturning otherwise substantively correct benefit denials because the plan administrator failed to provide a full and fair review of the denial through “meaningful dialogue” with the claimant.

His article consists of four parts. First, he outlines the ERISA’s full-and-fair-review requirement, which gives rise to the “meaningful dialogue” standard. Second, he examines how recent decisions, in particular DK v United Behavioral Health, 67 F. 4th 1224 (10th Cir. 2023), cert. denied 144 S. Ct. 808 (2024), have interpreted the “meaningful dialogue” standard when evaluating whether denial notices comply with ERISA. Third, Michael assesses whether DK and similar cases represent as dramatic a shift as some commentators have suggested. Finally, he offers practical tips to plan administrators for drafting denial notices that satisfy ERISA’s requirements, in light of recent court decisions.

• For The Defense: “Communication Breakdown” (March, 2026)