District Court Chastises Aetna for Committing Several ERISA Violations Through Its Denial of Disability Claims

Facing a long-term disability (“LTD”) claim, insurers often attempt to tip the scales against insureds in order to deny legitimate claims for benefits.  This imbalance can become especially pronounced where an insured primarily suffers from disabling conditions that are subjective in nature and difficult to objectively measure.  Instead of accepting the statements of physicians who …

Read moreDistrict Court Chastises Aetna for Committing Several ERISA Violations Through Its Denial of Disability Claims

The Basics of an ERISA Life, Health and Disability Insurance Claim – Part Nine: Insurer Reliance on Sub Rosa Surveillance

In this several-part blog series titled The Basics of an ERISA Life, Health and Disability Insurance Claim, we discuss the basics of an ERISA life, health, accidental death and dismemberment and disability claim, from navigating a claim to handling a claim denial and through preparing a case for litigation.  In Part Nine of this series, …

Read moreThe Basics of an ERISA Life, Health and Disability Insurance Claim – Part Nine: Insurer Reliance on Sub Rosa Surveillance

Top 5 Ways Insurance Companies Commit Insurance Bad Faith

The McKennon Law Group PC periodically publishes articles on its Insurance Litigation and Disability Insurance News blogs that deal with frequently asked questions in insurance bad faith, life insurance, long-term disability insurance, annuities, accidental death insurance, ERISA and other areas of law.  To speak with a highly skilled Los Angeles long-term disability insurance lawyer at …

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Insurers’ Bad Faith at Different Steps of the Insurance Claims Process

California law imposes an implied covenant of good faith and fair dealing in insurance contracts under which neither party may act so as to injure the rights of the other to receive benefits under the contract. Insurers whose actions harm the rights of their insureds to receive contracted-for insurance benefits breach this implied covenant of …

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Ninth Circuit Emphasizes Need for an Insurer to Have a Meaningful Dialogue With the Claimant When Denying Benefits

A recent Ninth Circuit Court of Appeals decision reaffirmed the need for plan administrators to state the reasoning behind their denial of coverage.  In Lukas v. United Behavioral Health,  __ F.3d __, 2013 U.S. App. LEXIS 1230 (9th Cir. Jan. 17, 2013) the Ninth Circuit was faced with evaluating whether the district court properly weighed …

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FAQs: What Kinds of Actions by an Insurer Constitute Bad Faith?

The McKennon Law Group PC periodically publishes articles on its California Insurance Litigation Blog that deals with frequently asked questions in the insurance bad faith and ERISA area of the law.  This is another such article in that series. Generally, to establish a bad faith claim in first party cases (such as those involving life, …

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Insurers Cannot Escape Bad Faith Liability By Relying On In-House Experts And The “Genuine Dispute Doctrine”

Insurers often wrongfully deny policy benefits to their insureds in situations where there may be some uncertainty as to coverage.  Despite an overarching duty to act reasonably and find in favor of coverage in such situations, insurers often will deny coverage and rely on their in-house medical experts’ (i.e., nurses, doctors) analysis and opinions as …

Read moreInsurers Cannot Escape Bad Faith Liability By Relying On In-House Experts And The “Genuine Dispute Doctrine”

Claim Administrator’s Failure to Contact Treating Physicians Found To Be An Abuse Of Discretion Under ERISA

Under ERISA, insurers/claim administrators are required to give every insurance claim a full and fair review. Courts in the Ninth Circuit have construed this requirement in a manner that requires insurers/claim administrators to do more than simply have an in-house physician or nurse conduct a paper review of medical records.  This trend continues with the …

Read moreClaim Administrator’s Failure to Contact Treating Physicians Found To Be An Abuse Of Discretion Under ERISA

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