From: John J. Spiegel [mailto:jspiegel@bellsouth.net] 

Sent: Friday, December 08, 2017 9:27 AM

To: EBSA, E-ORI - EBSA

Subject: 1210-AB39 Proposed Delay of Effective Date of Regulations

Dear Deputy Assistant Director Hauser:

I write to urge your Department to permit the new regulations pertaining to ERISA governed 

welfare plans providing disability benefits to go into effect on January 1, 2018 as scheduled. An 

exhaustive review and serious deliberations by your staff has already occurred. Further review is 

unnecessary.

I am an attorney and was first admitted more than 32 years ago. Over that time I have almost 

exclusively represented insureds, beneficiaries and policyholders in insurance claim disputes, the 

majority of which involved disability benefit claims. My practice is nearly a 50-50 mix of 

disability claim disputes governed by state law and those governed by ERISA. When I first 

began to handle the ERISA cases I was shocked at the stark differences made by whether the 

matter was governed by ERISA. I have seen countless examples of claims accepted and paid 

when state law applies and identical facts resulting in a claim denial when ERISA applies by the 

same insurance company. Colleagues whose law practice is like mine have all seen this over 

and over.

The simple reason for this is that the insurance companies and plan administrators enjoy 

immunity from extra-contractual damages, bad faith damages or punitive damages regardless of 

egregious, deceitful and fraudulent conduct. State law, however, typically allows for basic 

fairness and protections and allows an aggrieved claimant the opportunity to actually hold the 

carrier accountable. The specter of meaningful sanction is a powerful incentive for the carriers 

to behave themselves. Not always, but far more often than when ERISA applies.

Moreover, ERISA is so complicated and so loaded with potential pitfalls, it is practically 

impossible for a claimant to navigate an adverse benefit decision appeal without the assistance of 

ERISA experienced counsel. Even lawyers not familiar with ERISA are prone to made serious 

mistakes in handling such matters. 

A new game played by the insurance companies and plans is to refuse to answer the simple 

question of when the statute of limitations to file an action expires. An old game played is to 

demand an IME during the pendency of an ERISA appeal, hire a biased examiner, concoct a 

brand new reason to uphold the benefits denial and refuse to allow the claimant to rebut the 

new report (sandbagging).

The plans and insurance companies allege that premiums will rise if the new regulations go into 

effect, based on purported "data" only the insurance companies have seen. This is just another 

sandbagging effort, and that argument has already been rejected by your staff. Sandbagging is a 

lucrative practice for the carriers, so much so that they pray to be permitted to continue to do 

it. Don't let them.
Fundamental fairness demands that the new regulations be allowed to go into effect, and that 

should occur as scheduled on January 1, 2018.

Thank you for your consideration.

John J. Spiegel, Esq.

John J. Spiegel, P.A.

14901 Bald Eagle Drive

Fort Myers, FL 33912

305-804-3051