2015 Decisions

Opinions of the United

States Court of Appeals

for the Third Circuit

8-26-2015

Neville Mirza v. Insurance Admin of America Inc

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"Neville Mirza v. Insurance Admin of America Inc" (2015). 2015 Decisions. Paper 920.

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PRECEDENTIAL

UNITED STATES COURT OF APPEALS

FOR THE THIRD CIRCUIT

No. 13-3535

DR. NEVILLE M. MIRZA, M.D., on assignment of N.G.,

 Appellant

v.

INSURANCE ADMINISTRATOR OF AMERICA, INC.; 

THE CHALLENGE PRINTING OF THE CAROLINAS, 

INC.; JOHN/JANE DOES 1-10; 

ABC CORP. 1-10; ABC PARTNERSHIPS

_____________

On Appeal from the United States District Court

for the District of New Jersey

(D.C. Civil Action No. 1-12-cv-07370)

District Judge: Honorable Renee M. Bumb

_____________

Argued: May 19, 2015

Before: FUENTES, GREENAWAY, JR., and SLOVITER,

Circuit Judges

(Opinion Filed: August 26, 2015)
2

Matthew R. Major, Esq. [ARGUED]

Michael J. Smikun, Esq.

Callagy Law

650 From Road

Suite 565

Paramus, NJ 07652

Attorneys for Appellant, Dr. Neville Mirza, M.D., on 

assignment of N.G.

Natalie D’Amora, Esq.

Archer & Greiner

1650 Market Street

One Liberty Place, 32nd Floor

Philadelphia, PA 19103

Attorneys for Appellee, Insurance Administrator of 

America, Inc.

Natalie D’Amora, Esq.

Archer & Greiner

1650 Market Street

One Liberty Place, 32nd Floor

Philadelphia, PA 19103

Mark J. Oberstaedt, Esq. [ARGUED]

Archer & Greiner

One Centennial Square

33 East Euclid Avenue

Haddonfield, NJ 08033
3

Attorneys for Appellee, The Challenge Printing of the 

Carolinas, Inc.

OPINION OF THE COURT

FUENTES, Circuit Judge.

The regulations implementing the Employee 

Retirement Income Security Act of 1974 (“ERISA”), 29 

U.S.C. § 1001 et seq., provide that when a plan administrator 

denies a request for benefits, it must set forth 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.” 29 C.F.R. § 2560.503-

1(g)(1)(iv). The ERISA plan at issue in this case contains a 

one-year deadline for filing a civil action. Appellant Dr. 

Neville Mirza received a benefits denial letter advising him of

his right to judicial review, but it did not mention the time 

limit for doing so. The principal question we address is 

whether plan administrators must inform claimants, of planimposed deadlines for judicial review, in their notifications 

denying benefits. We hold that they must, and that the 

appropriate remedy for this regulatory violation is to set aside 

the plan’s time limit and apply the limitations period from the 

most analogous state-law cause of action—here, New 

Jersey’s six-year deadline for breach of contract claims. 

Because Mirza filed his complaint before the expiration of 

this six-year limitations period, we vacate and remand for 

further proceedings. 
4

I.

“N.G.” is an employee of The Challenge Printing 

Company of the Carolinas (“Challenge”) and a participant in

her employer’s ERISA plan. The plan documents contain a 

section on claims procedures, which provides a framework 

for the submission and review of claims for benefits. If a 

claimant receives an adverse initial benefit decision, she may 

appeal that determination through an internal review process. 

Once the claimant exhausts that process and receives a final 

decision from the plan administrator, the claimant has one 

year to bring a legal action for benefits. 

In April 2010, N.G. consulted with Dr. Neville Mirza 

about severe back pain she was experiencing. Mirza 

diagnosed N.G. with a herniated disc and recommended she 

undergo an endoscopic discectomy. N.G. agreed to the 

proposed treatment plan and executed an assignment of 

benefits form that assigned to Mirza “any and all rights that 

[N.G.] may have including but not limited to [her] [personal 

injury protection] carrier for any payment of outstanding 

medical bills incurred with [Mirza].” App. 174. The parties 

agree that through this assignment Mirza stepped into the 

shoes of N.G. for purposes of pursuing any rights the latter

might have under ERISA. Mirza performed the procedure on 

N.G.’s back and submitted a claim for $34,500 to Insurance 

Administrator of America (“Insurance Administrator”), the 

company charged with processing claims under Challenge’s 

ERISA plan. 

Insurance Administrator first denied the claim on June 

2, 2010, explaining that supporting documentation was 

missing. Mirza submitted additional documents in response 
5

to this denial, but the claim was denied again. Mirza worked 

his way through the internal review process and, on August 

12, 2010, he received a letter denying his final appeal. 

Insurance Administrator found that the medical procedure on 

N.G.’s back was not a covered benefit because it was 

medically investigational. At the end of the letter, Insurance 

Administrator informed Mirza of his “right to bring a civil 

action under ERISA § 502(a)” if he was not content with this 

final decision.1 App. 233. Neither the August 12 letter nor 

any of the earlier denials mentioned that, under the plan, 

Mirza had one year from the date of the final benefits denial 

to seek judicial review. At some point after Mirza received 

the August 12 letter, he retained the law firm of Callagy Law.

Around the same time that N.G. first visited Mirza in 

April 2010, she also met with Spine Orthopedics Sports 

(“Spine”). N.G. likewise assigned her benefits to Spine, 

which, after providing anesthesia services to N.G., submitted 

a claim to Insurance Administrator for benefits under the 

ERISA plan. After Insurance Administrator made only 

partial payment on the claim, Spine, like Mirza, retained 

Callagy Law to represent it in the benefits dispute. On 

November 23, 2010, an employee from Insurance 

Administrator spoke on the telephone with someone from 

Callagy Law about Spine’s claim for benefits. It is not clear 

what was said on this phone call. According to Insurance 

Administrator, its employee read verbatim the plan language 

about the one-year deadline for filing suit following the final 

denial of benefits. By Callagy Law’s account, the employee 

from Insurance Administrator said only that “a patient self-

 

1 Section 502(a) is codified in 29 U.S.C. § 1132(a).
6

funded plan allows 12 months to appeal.” App. 176 (internal 

quotation marks omitted). Several months later, an attorney 

from Callagy Law, in connection with its representation of 

Spine, requested a copy of the ERISA plan documents, which 

included the time limit for judicial review. Callagy Law 

received the plan documents on April 11, 2011. While the 

parties debate the substance of the November 23, 2010 phone 

call, it is undisputed that the first time either Mirza or Callagy 

Law received written notice of the one-year deadline was on 

April 11, 2011. 

On March 8, 2012—almost 19 months after he

received the August 12, 2010 denial letter—Mirza sued 

Insurance Administrator for unpaid benefits.2 Mirza 

thereafter filed an amended complaint, this time against both 

Insurance Administrator and Challenge (collectively, 

“Defendants”), asserting breach of contract (Count One), and

claims under 29 U.S.C. § 1132(a) for violating ERISA by 

improperly denying benefits (Count Two) and for an 

administrator’s failure to supply requested information 

(Count Three). The District Court granted Defendants’

motion to dismiss as to Counts One and Three—neither of 

which is the subject of this appeal—and denied it as to Count 

Two. With respect to Count Two, the District Court directed 

the parties to exchange information on the issue of whether 

the claim was time-barred in light of the plan’s one-year 

limitations period. Following limited discovery, the District 

Court converted the motion to dismiss into one for summary 

judgment and ruled for Defendants.

 

2 Spine is not a party to this litigation.
7

The District Court disposed of Mirza’s claim for 

benefits through a three-step analysis. First, it held the plan’s 

one-year deadline for seeking judicial review was enforceable 

because it was not unreasonable. Next, it observed that, 

absent equitable tolling, Mirza’s suit was time-barred because 

it was filed more than one year after the final denial of 

benefits. Finally, the District Court found Mirza was not 

entitled to equitable tolling because he had notice of the oneyear deadline for suing Defendants. Recognizing there was 

no evidence that Mirza himself was aware of the deadline, the 

District Court imputed Callagy Law’s knowledge to Mirza. 

In its view, “[Mirza], through his counsel, was on notice of 

the time limit well in advance of the August 12, 2011 statute 

of limitations end date. [Mirza’s] counsel was notified of the 

time limit orally on November 23, 2010 and received a copy 

of the plan on April 11, 2011 in connection with the Spine 

appeal, which dealt with the same patient—N.G.—and same

plan.” Mirza v. Ins. Adm’r of Am., Inc., No. 12-7370, 2013 

WL 5642587, at *5 (D.N.J. July 19, 2013). Because it held 

Mirza had notice of the contractual time limitation, the 

District Court said it did not need to address Mirza’s 

argument that Defendants violated ERISA by not specifically 

informing him of the one-year deadline in the August 12 

denial letter.3

 

3 The District Court had jurisdiction under 28 U.S.C. §§ 1331

and 1367, and we have jurisdiction to review the District 

Court’s final order under 28 U.S.C. § 1291. We exercise 

plenary review over the District Court’s grant of summary 

judgment and will affirm only if, “viewing the underlying 

facts and all reasonable inferences therefrom in the light most 

favorable to the party opposing the motion, we conclude that 
8

II.

Our approach to this case proceeds along a different 

path from that taken by the District Court because we do not 

find equitable tolling to be an obstacle, or even relevant, to 

Mirza’s claim. Instead, we focus our analysis on the issue the 

District Court avoided, namely, whether Defendants violated

their regulatory obligations by failing to include the planimposed one-year time limit for seeking judicial review in the 

letter denying Mirza’s request for benefits.

4

 We do so 

because that issue—and not equitable tolling—controls.

ERISA provides that a participant or beneficiary may 

bring a civil action “to recover benefits due to him under the 

terms of his plan.” 29 U.S.C. § 1132(a)(1)(B). The statute, 

however, does not prescribe any limitations period for filing 

such an action. When a statute does not provide a limitations 

period for filing a claim, we borrow the statute of limitations

from the most analogous state-law claim, which in this case is 

breach of contract. See Hahnemann Univ. Hosp. v. All Shore, 

 

a reasonable jury could not rule for the nonmoving party.” 

E.E.O.C. v. Allstate Ins. Co., 778 F.3d 444, 448 (3d Cir. 

2015) (internal citations and quotation marks omitted).

4 We see no reason to remand to the District Court to decide 

this issue in the first instance. It is “generally appropriate” 

for an appellate court to reach the merits of an issue not 

decided by the district court if “the factual record is 

developed and the issues provide purely legal questions, upon 

which an appellate court exercises plenary review.” Hudson 

United Bank v. LiTenda Mortg. Corp., 142 F.3d 151, 159 (3d 

Cir. 1998).
9

Inc., 514 F.3d 300, 305-06 (3d Cir. 2008). The parties agree 

the default limitations period for Mirza’s claim is six years, 

which is the deadline for filing a breach of contract action 

under New Jersey law. See N.J. Stat. Ann. § 2A:14-1. 

However, because an ERISA plan is nothing more than a 

contract, parties may agree to a shorter limitations period so 

long as the contractual period is not unreasonable. See

Hahnemann Univ., 514 F.3d at 306.

The ERISA plan here provides that “no legal action 

may be commenced or maintained to recover benefits under 

the Plan more than 12 months after the final review/appeal 

decision by the Plan Administrator has been rendered.” App. 

155. Mirza’s suit is facially time-barred because he received 

the final denial letter on August 12, 2010, but he did not file 

suit until March 8, 2012. Mirza’s pursuit of benefits is 

therefore doomed unless he can persuade us of a reason to toll 

or set aside the plan’s contractual deadline. To that end, 

Mirza does not claim on appeal that the one-year deadline is 

unreasonably short. Instead, he first argues that equitable 

tolling is warranted because he had no actual notice of the 

one-year deadline for suing Defendants. Mirza points out that 

the only supposed evidence of notice is that his retained law 

firm, Callagy Law, in connection with representing another 

client, Spine, was informed of the contractual limitation on a 

phone call and received a copy of the plan documents. In 

those circumstances, Mirza maintains, we cannot attribute 

Callagy Law’s knowledge to him. Second, Mirza urges us to 

either equitably toll or set aside the one-year deadline for 

filing suit because Insurance Administrator was required to, 

but did not, inform him of the time limit for judicial review in 

its adverse benefit determination. We discuss the second 

argument first.
10

A.

ERISA tasks the Secretary of Labor with promulgating 

regulations governing the claims procedure process. 29 

U.S.C. § 1133. Exercising that authority, the Department of 

Labor issued extensive regulations setting forth the minimum 

requirements for plan procedures pertaining to claims for 

benefits. See generally 29 C.F.R. § 2560.503-1. One 

subsection of those regulations is at the core of this case. 

Subsection (g), titled “[m]anner and content of 

notification of benefit determination,” provides that the plan 

administrator shall provide a claimant with written 

notification of any adverse benefit determination. Id.

§ 2560.503-1(g)(1). And in those written notifications, the 

administrator shall set forth 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 following 

an adverse benefit determination.” Id. § 2560.503-

1(g)(1)(iv). We must decide whether this regulation requires 

plan administrators to inform claimants of plan-imposed time 

limits for bringing civil actions in their adverse benefit 

determinations. If it does, Defendants violated this provision 

by not including the plan deadline in the August 12, 2010 

letter denying Mirza’s benefits.

As with any exercise in statutory interpretation, we 

begin with the text. The parties, of course, offer competing 

visions of what this regulation mandates. A claimant’s “right 

to bring a civil action,” Mirza says, is one of the “review 

procedures” for which “time limits” must be disclosed. 
11

Defendants respond that § 2560.503-1(g)(1)(iv) refers to two 

distinct requirements. The first requirement is based on the

text that precedes the comma (i.e., notice of the plan’s review 

procedures and applicable time limits for those procedures), 

and the second is based on the text that follows (i.e., notice of 

the right to sue). In other words, Defendants take the position 

that the notice of the right to sue is in addition to and entirely 

separate from the notice of the plan’s review procedures. As 

one district court put it, “[t]hat the regulation requires 

notification of time limits for plan review procedures but says 

nothing about time limits with respect to civil actions 

suggests that the [Department of Labor] did not intend to 

require such a time limit notification in the benefit 

determination.” Heimeshoff v. Hartford Life & Accident Ins. 

Co., No. 10-1813, 2012 WL 171325, at *6 (D. Conn. Jan. 20, 

2012), aff’d, 496 F. App’x 129 (2d Cir. 2012), aff’d, 134 S. 

Ct. 604 (2013). This makes sense, Defendants believe, 

because a civil action seeking remedies under the plan is a 

separate review process from those contemplated by the 

internal claims proceedings. 

We disagree with Defendants’ view and find the plain 

language of the regulation supports Mirza’s construction. For 

purposes of interpretation, the most important word in the 

sentence is “including.” “[I]ncluding” modifies the word 

“description,” which is followed by a prepositional phrase 

explaining what must be described—the plan’s review 

procedures and applicable time limits for those procedures. If 

the description of the review procedures must “includ[e]” a 

statement concerning civil actions, then civil actions are 

logically one of the review procedures envisioned by the 

Department of Labor. And as with any other review 
12

procedure, the administrator must disclose the plan’s 

applicable time limits. 

Defendants’ arguments to the contrary fail to explain 

how the clause regarding the right to sue fits within the 

structure of the sentence. The argument that the language

speaks to time limits for plan procedures but is silent as to 

time limits for civil actions reads the word “including” out of 

the regulation. It also assumes, without explanation, that civil 

actions cannot be considered plan review procedures. But 

that interpretation contravenes the text of the regulation. In 

any case, to the extent § 2560.503-1(g)(1)(iv) is ambiguous, 

we construe it broadly and in favor of Mirza because ERISA 

is a remedial statute. See Brown v. J.B. Hunt Transp. Servs., 

Inc., 586 F.3d 1079, 1086 (8th Cir. 2009).

Both Courts of Appeals that have addressed this issue 

agree with our interpretation of the regulation. See Moyer v. 

Metro. Life Ins. Co., 762 F.3d 503, 505 (6th Cir. 2014) (“We 

agree with [claimant] that on the date his revocation letter 

was sent, it was required to include the time limit for judicial 

review.”); id. (“The claimant’s right to bring a civil action is 

expressly included as a part of those procedures for which 

applicable time limits must be provided.”); Ortega 

Candelaria v. Orthobiologics LLC, 661 F.3d 675, 680 (1st 

Cir. 2011) (“[Defendant] was required by federal regulation 

to provide [plaintiff] with notice of his right to bring suit 

under ERISA, and the time frame for doing so, when it denied 

his request for benefits.”); id. at 680 n.7 (“We think it clear 

that the term ‘including’ indicates that an ERISA action is 

considered one of the ‘review procedures’ and thus notice of 

the time limit must be provided.”).
13

Defendants direct us to two other cases from the 

Courts of Appeals. See Scharff v. Raytheon Co. Short Term 

Disability Plan, 581 F.3d 899 (9th Cir. 2009); Heimeshoff v. 

Hartford Life & Accident Ins. Co., 496 F. App’x 129 (2d Cir. 

2012) (unpublished). In Scharff, the benefits denial letter

mentioned the claimant’s right to bring an ERISA action but 

did not reference the plan’s contractual one-year limitations 

period. 581 F.3d at 902-03. When the plaintiff filed an 

untimely suit, she did not rely on § 2560.503-1(g)(1)(iv) to 

excuse delay. Rather, she argued that, by failing to disclose 

the deadline, the defendant violated the “reasonable 

expectations doctrine,” which, the court explained, has been 

incorporated into ERISA federal common law. Id. at 903-05. 

The court disagreed, and held that the defendant’s disclosures 

in other documents were sufficient. Id. at 906. Scharff is not 

helpful to Defendants here because it was decided under 

federal common law and the court did not even mention 

§ 2560.503-1(g)(1)(iv), much less interpret it. Similarly, in 

Heimeshoff, an unpublished case, the Second Circuit also did 

not speak to the meaning of this provision. 496 F. App’x at 

130. The plaintiff there urged the court to find that 

§ 2560.503-1(g)(1)(iv) requires the disclosure of time limits 

for civil actions. But the court said it “need not address this 

issue” because the plaintiff had notice of the limitation and 

was therefore not entitled to equitable tolling.5 Id. at 130-31. 

 

5 For reasons explained below, we disagree with the finding 

in Heimeshoff that a claimant’s notice of the filing deadline 

can work to the benefit of a defendant who violates the terms 

of § 2560.503-1(g)(1)(iv).
14

In addition to the regulatory text and the relevant 

decisions from the Courts of Appeals, practical considerations

also support our interpretation of the regulation. For starters, 

this case exemplifies how, were we to endorse Defendants’ 

position, plan administrators could easily hide the ball and 

obstruct access to the courts. The ERISA plan at issue here is 

ninety-one pages. The one-year time limit is buried on page 

seventy-three of the plan. The August 12 letter denying 

Mirza’s final appeal is only five pages. Which is a claimant 

more likely to read—a ninety-one page description of the 

entire plan or a five-page letter that just denied thousands of 

dollars in requested benefits? Furthermore, by not creating a 

statute of limitations for ERISA actions brought under 29 

U.S.C. § 1132(a), Congress, in effect, delegated this authority 

to plan administrators and fiduciaries to come up with their 

own deadlines for judicial review. Without the plan-imposed 

deadline here, we would have applied the New Jersey statute 

of limitations for breach of contract, and Mirza would have 

had six years to file suit. The plan substantially narrowed that 

window, shortening the deadline from six years to one. 

While this was likely reasonable as a matter of contract law, 

the Department of Labor obviously thought it important to 

make sure claimants were aware of these substantially 

reduced limitations periods. One very simple solution, which 

imposes a trivial burden on plan administrators, is to require 

them to inform claimants of deadlines for judicial review in 

the documents claimants are most likely to actually read—

adverse benefit determinations. Section 2560.503-1(g)(1)(iv) 

does just that.

Defendants offer additional arguments against finding 

a regulatory violation. They suggest that Mirza’s reading of 

the regulation would put plan administrators in the precarious 
15

position of having to provide legal advice to plan participants. 

Defendants argue that, where an ERISA plan itself does not 

contain a limitations period, the administrators would have to

research the applicable statute of limitations for judicial 

review, which may vary from state to state and claimant to 

claimant. These are reasonable concerns, but our holding is 

narrower than that feared by Defendants. We conclude only 

that § 2560.503-1(g)(1)(iv) requires written disclosure of 

plan-imposed time limits on the right to bring a civil action. 

We express no view on the applicability of this provision to 

ERISA plans that are silent as to limitations periods and thus 

borrow from analogous state-law claims.

Defendants argue that ERISA requires only substantial 

compliance, not strict compliance, and that, at most, any 

shortcoming in the denial letter was a technical violation of 

the regulations. We acknowledge courts have found that, as 

Defendants observe, substantial compliance with ERISA’s 

notice requirements is all that is necessary. See, e.g., 

Gagliano v. Reliance Standard Life Ins. Co., 547 F.3d 230, 

237 (4th Cir. 2008). We agree with the Sixth Circuit in 

concluding that the “failure to include the judicial review time 

limits in the adverse benefit determination letter renders the 

letter not in substantial compliance with § 1133.” Moyer, 762 

F.3d at 506. One of the purposes of 29 U.S.C. § 1133, which 

is the statutory foundation for the regulations governing 

claims procedures, is to provide claimants with adequate 

information to ensure effective judicial review. See id. at 

507; Brown, 586 F.3d at 1086. The disclosure of a reduced 

time limitation in a denial letter ensures a fair opportunity to 

review by making it readily apparent to a claimant that he or 
16

she may have only one year—or even much less than that6—

before the courthouse doors close.

Accordingly, we hold that 29 C.F.R. § 2560.503-

1(g)(1)(iv) requires that adverse benefit determinations set 

forth any plan-imposed time limit for seeking judicial review. 

Without this time limit, a notification is not in substantial 

compliance with ERISA. Defendants in this case violated 

this regulation by not including in the August 12, 2010 denial 

letter the plan’s one-year deadline for bringing a civil action.

B.

According to Defendants, none of our analysis thus far 

matters. They argue that regardless of whether there is a 

regulatory violation, there is no basis for equitably tolling the

contractual limitation because Mirza was on notice of the 

one-year filing deadline. The District Court agreed. It found 

that Mirza’s law firm, Callagy Law, was informed of the time 

limit during a November 2010 phone call and received the 

plan documents with the deadline in April 2011. Though 

Callagy Law acquired this information during its 

representation of another client (Spine), the District Court 

nonetheless imputed Callagy Law’s notice to Mirza.

Assuming Mirza was in fact on notice, Defendants’

argument is not without some support. As mentioned earlier, 

the Second Circuit, in an unpublished opinion, concluded that 

 

6 See, e.g., Northlake Reg’l Med. Ctr. v. Waffle House Sys. 

Emp. Benefit Plan, 160 F.3d 1301, 1304 (11th Cir. 1998) 

(finding ninety-day deadline reasonable).
17

a claimant’s delay in filing her ERISA suit could not be saved 

by the defendant’s alleged violation of § 2560.503-1(g)(1)(iv) 

because she conceded she had a copy of the plan that 

contained the three-year limitations provision. See

Heimeshoff, 496 F. App’x at 130-31. Because she had actual 

notice, she was not entitled to equitable tolling. Id. at 131-32. 

In addition, Defendants attempt to distinguish the two 

decisions from the Courts of Appeals finding that the 

disclosure of time limits is required by arguing that the 

claimants in those cases unambiguously did not have notice 

of the plan’s deadline.7 In those circumstances, Defendants 

say, it was appropriate to equitably toll the limitations period. 

By contrast, Mirza was on notice and there is no similar basis 

for excusing his untimely filing.

Though we have some doubt as to whether the District 

Court erred in finding Mirza on notice through his law firm,8

we need not decide that issue. In our view, the doctrine of 

equitable tolling should not bear on Mirza’s case. If we 

 

7 Moyer, 762 F.3d at 505 (“Being unaware of the contractual 

time limit, [claimant] filed his complaint late.”); Ortega 

Candelaria, 661 F.3d at 681 (“It is uncontested that 

[defendant] never informed [claimant] of the one-year 

limitation.”). 

8 See Epright v. Envtl. Res. Mgmt., Inc. Health & Welfare 

Plan, 81 F.3d 335, 342 (3d Cir. 1996) (“The fact that 

[plaintiff’s] attorney had a copy of the plan, and thus the 

means to ascertain the proper steps for requesting review, in 

no way excuses [defendant’s] failure to comply with the 

Department of Labor’s regulations.”).
18

allowed plan administrators in these circumstances to respond 

to untimely suits by arguing that claimants were either on 

notice of the contractual deadline or otherwise failed to 

exercise reasonable diligence, plan administrators would have 

no reason at all to comply with their obligation to include 

contractual time limits for judicial review in benefit denial 

letters. Instead, they could almost invariably argue that the 

contractual deadline was in the plan documents and that 

claimants are charged with knowledge of this fact. But that

approach would render hollow the important disclosure 

function of § 2560.503-1(g)(1)(iv). As we mentioned earlier, 

we believe claimants are much more likely to read benefit 

denial letters than the voluminous descriptions of their entire 

ERISA plans.

The better course here is to set aside the plan’s oneyear deadline for filing suit. We have previously found that 

“[w]hen a letter terminating or denying Plan benefits does not 

explain the proper steps for pursuing review of the 

termination or denial, the Plan’s time bar for such a review is 

not triggered.” Epright, 81 F.3d at 342.9 Because the denial 

letter Mirza received on August 12, 2010 did not comply with 

the regulatory requirements, the one-year deadline for judicial 

 

9 See also Syed v. Hercules Inc., 214 F.3d 155, 162 (3d Cir. 

2000) (“Where a termination letter does not comply with the 

statutory and regulatory requirements, the time limits for 

bringing an administrative appeal are not enforced against the 

claimant.”); Burke v. Kodak Ret. Income Plan, 336 F.3d 103, 

107 (2d Cir. 2003) (same); White v. Jacobs Eng’g Grp. Long 

Term Disability Benefit Plan, 896 F.2d 344, 350 (9th Cir. 

1989) (same).
19

review was not triggered. We will instead borrow the statute 

of limitations from the most analogous state-law claim, which 

the parties agree is New Jersey’s six-year deadline for breach 

of contract actions. See N.J. Stat. Ann. § 2A:14-1; 

Hahnemann Univ., 514 F.3d at 305-06. Mirza filed his 

complaint on March 8, 2012, well before the six-year 

limitations period for breach of contract expired. 

Accordingly, the District Court erred by dismissing his suit as 

untimely.

III.

For the foregoing reasons, we vacate the order of the 

District Court and remand for further proceedings consistent 

with this opinion.