In US Airways, Inc. v. McCutchen, 2011 WL 5557411 (3rd Cir. Nov. 16, 2011), an ERISA plan sought reimbursement of 100% of what it had paid for medical bills for a car crash victim even though the victim had not been fully reimbursed because of limited liability coverage. The lawyers for the car crash victim … Continue Reading
My client took out a short term disability policy in December of 2010. He then suffered a stroke in May of this year. His short term disability carrier denied the claim, asserting that the stroke was a preexisting condition. You won’t be surprised to hear that I filed a lawsuit against the STD carrier for breach of … Continue Reading
My client suffers from a couple of different debilitating medical conditions. He purchased an AFLAC policy at work, which was supposed to pay him when he was off work as a result of illness or injury. The maximum benefit was for 6 months, at which point AFLAC would not pay anymore for that particular medical … Continue Reading
My client was severely injured in a motorcycle accident. In a bad faith lawsuit against the at-fault driver’s insurance company we recovered a confidential amount well in excess of 150 times the policy limits. My client’s health insurer paid around $200,000 for medical care related to the crash. After resolving the bad faith case, my client’s health insurer … Continue Reading
My client was injured in an automobile accident. My client was an HMO member through his employer. The HMO was issued by Blue Cross and Blue Shield of Florida. After the accident, Blue Cross and Blue Shield provided some medical services to my client that were accident related, and also provided some services that were not related … Continue Reading
You are much more likely to become disabled during your work life than to die during your work life. Thus, disability insurance is very important to protect you and your family from financial ruin in the event of a disability. But, what happens when you insurance company denies your disability claim… Continue Reading
Recently, we prevailed in federal court on a contract interpretation issue under an ERISA short term disability insurance policy. Due to an illness, our client could not perform some of the essential duties of her job. She could perform some of her duties, she just couldn’t perform them all. Our client filed a claim for STD benefits … Continue Reading
My client’s brother was riding his motorcycle when another driver turned left in front of him. The motorcyclist struck the front right corner of the car. The motorcyclist died at the scene. The driver of the car received a ticket for violation of right of way. The motorcyclist was not speeding, and was not found to be … Continue Reading
My client’s husband had a seizure and fell in his home. He struck his head on the floor which resulted in a traumatic brain injury. Tragically, he later died of the TBI. At the time of his death, he was a plan participant in an ERISA benefits plan sponsored by his employer. One of his … Continue Reading
Life Insurance Company of North America (“LINA”) was recently ordered to continue paying disability benefits under an ERISA governed Plan. In that case, the our client was employed by UBS as a senior sales brokerage assistant earning over $100,000.00 a year. She left work as a result of a heart condition and fibromyalgia which caused … Continue Reading
Our client was insured under a self-funded long term disability plan which was administered by Aetna Life Insurance Company. Our client filed an LTD claim based on his anxiety, panic disorder and agoraphobia. Aetna initially approved the claim, but later terminated benefits and denied the claim. We filed suit in Federal Court and the judge … Continue Reading
ERISA – Statute of Limitations One of the most perplexing issues that arise in ERISA cases is the applicable statute of limitations. The ERISA statute itself does not provide a specific statute of limitations for claims for benefits. Instead, Courts look to the Plan document, the insurance policy, and/or state law in making such a … Continue Reading
My client is a veterinarian who became disabled due to cancer and the subsequent grueling treatments. Her disability insurance carrier is New York Life. Although New York Life has not technically denied the claim they might as well have. Instead of quickly processing the claim, their claims administrator has repeatedly requested the same information time and again. Once … Continue Reading
You buy short term disability and long term disability insurance in order to protect yourself and your family. In many cases, the insurance company denies the disability claim from the beginning. Other times, the disability insurer approves a claim only to terminate benefits later. As a lawyer for the disabled, I help people with claims that … Continue Reading
The Nation Law Firm recently filed an administrative appeal for certain disability benefits under the terms of the Harris Corporation Disability Plan. Plaintiff was successful in this appeal and benefits were reinstated. The Nation Law Firm recently handled an administrative appeal under an ERISA plan against Principal Life Insurance Company. Plaintiff prevailed in the appeal … Continue Reading
We recently filed a lawsuit seeking certain short term disability benefits under the terms of the Federal Express Short Term Disability Plan. Litigation continues. We also recently filed suit seeking short term disability benefits under the terms of the Blue Cross and Blue Shield of Florida Short Term Disability Plan. Plaintiff was an employee of … Continue Reading
The Nation Law Firm recently filed suit against CUNA Mutual Insurance Society for certain credit disability insurance benefits. (Often borrowers will take out credit disability insurance to pay their loan payments in the event of disability). In this case, our client became disabled and applied for disability benefits. The insurer, CUNA, denied the claim, arguing … Continue Reading
The Nation Law Firm recently filed a complaint seeking disability benefits on behalf of a pastor who became disabled. Suit was filed against Unum Life Insurance Company of America. Although the matter was not governed by ERISA, the case was removed to federal court allegedly based on diversity. Plaintiff is seeking to remand the case … Continue Reading
I filed suit today against Standard Insurance Company on behalf of a former firefighter whose LTD benefits were recently terminated. After paying LTD benefits for two years, the insurer has advised my client that they are cutting off the benefits. As with most of these cases, if I win, the insurance company must pay all or … Continue Reading
In Holmstrom v. Metropolitan Life Insurance Company, 2009 WL 901127 (N.D. Ill. March 31, 2009), Holmstrom sued Metropolitan for terminating her long term disability payments. Metropolitan counterclaimed seeking reimbursement from Holmstrom for an overpayment of LTD benefits which occurred when Holmstrom received a payment for back benefits from social security disability. (The Metropolitan plan contained a … Continue Reading
We recently filed suit against Hartford Life and Accident Insurance Company for denying our client’s claim for Long Term Disability benefits. Our client was a salesman working for a chemical company. He suffered from intractable pain, and applied for and received short term disability benefits. He then received long term disability benefits for 24 months. … Continue Reading
Our client’s Long Term Disability claim was denied by Hartford. At the time he became disabled, our client worked as a cruise ship engineer working for Disney Worldwide Services, Inc. He suffered from a severe stomach condition and was unable to work. Litigation continues… Continue Reading
