Part 23 · Chapter 3

Claims Defense, DOL Investigations, and Litigation Process

Law stated as of October 3, 2026 · ERISA Disputes, Enforcement, Preemption, and Remedies

Scope and status

This chapter covers the process layer of ERISA disputes: exhaustion, the standard of review (Firestone/Glenn/Conkright), the administrative record and discovery limits (including the fiduciary exception to privilege), litigation holds and preservation, a litigation-facing overview of DOL/EBSA investigations, and insurer-versus-plan allocation of liability and defense. Scope discipline: this Part supports doctrine and compliance posture — litigation strategy, forum and motion decisions, and case handling are expressly reserved for litigation counsel.

Citations are to primary authority (ERISA §§104, 107, 209, 502, 504; 29 C.F.R. §2560.503-1; and controlling case law). Related questions are treated elsewhere: claims-procedure mechanics (§503, the 2560.503-1 requirements, disability rules) in Part 4 (Reporting, Disclosure, Recordkeeping, and Claims); §502 doctrine and remedies in this Part's litigation chapter; fiduciary-breach substance and VFCP in Part 3 (Fiduciary Duties and Prohibited Transactions); and the full DOL/EBSA investigation-process mechanics (document requests, interviews, the VC-letter arc, response practice, current enforcement priorities) in Part 22 (Government Audits and Investigations).

Sections

The opening sections of Part A are shown in full. The other sections are listed by title; their text is available to subscribers.

Part A — Exhaustion and the Standard of Review

A1.Exhaustion

Part 23, ch. 3, § A1

Benefit claimants must generally exhaust the plan's administrative remedies before suing under (a)(1)(B) — a judge-made doctrine, near-universal across circuits — subject to futility and inadequate-remedy exceptions (both narrowly applied) and to deemed exhaustion: when the plan fails to establish or follow claims procedures consistent with the §503 claims-procedure regulation, the claimant is deemed to have exhausted and proceeds to court (§2560.503-1(l)(1)) — with de novo review the usual consequence. For disability claims the standard is strict adherence, subject to a narrow de minimis exception (no likely prejudice or harm, good cause or matters beyond the plan's control, an ongoing good-faith exchange, and no pattern or practice) (§2560.503-1(l)(2)); for other benefits, circuits differ on whether minor or harmless lapses are excused. Exhaustion of statutory (fiduciary-breach) claims is not required in most circuits. Plans may (and should) make exhaustion an express plan term. Final reg: 29 C.F.R. §2560.503-1(l); Case law: circuit consensus doctrine.

A2Standard of review — Firestone, Glenn, ConkrightSubscribers
A3The administrative record and discoverySubscribers

Part B — Preservation and Litigation Holds

B1The holdSubscribers

Part C — DOL/EBSA Investigations (litigation-facing overview)

C1Authority and the litigation postureSubscribers

Part D — Insurer-Versus-Plan Allocation

D1Who defends and who pays, by structureSubscribers

The first Part of each chapter is open to everyone. The remaining sections, with their authority and practice points, are available to subscribers and to clients of ERISA Benefits Law Group, PLLC whose engagement includes access.