In an Important Ruling in a McKennon Law Group PC Case, Judge Stephen Wilson Rules That Temporary Life Insurance Policy Was Potentially Created

Many people acquire life insurance in order to guarantee that their loved ones are provided for in the event of their death.  For most people, the policy is acquired, and it just becomes another monthly bill they rarely think about.  However, on occasion, life takes a tragic turn and the insured who just applied for a …

Read moreIn an Important Ruling in a McKennon Law Group PC Case, Judge Stephen Wilson Rules That Temporary Life Insurance Policy Was Potentially Created

Court Denies Insurer’s Motion to Dismiss, Finding Plan Language Did Not Clearly Require Administrative Exhaustion Prior to Filing Suit

Ordinarily, a participant or beneficiary of a plan governed by the Employee Retirement Income Security Act of 1974 (“ERISA”) must avail himself or herself of the plan’s internal review procedures before bringing a civil action in federal court for recovery of plan benefits.  This includes group ERISA plans offering long-term disability, life, health or accidental …

Read moreCourt Denies Insurer’s Motion to Dismiss, Finding Plan Language Did Not Clearly Require Administrative Exhaustion Prior to Filing Suit

Tenth Circuit Finds that Policy Terms in an ERISA Plan Did Not Unequivocally Grant an ERISA Administrator Discretion to Interpret Plan Terms, Applies De Novo Review

Insurance companies acting as ERISA plan administrators often are guilty of abusing their discretion to interpret policy language related to the level of benefits payable to a claimant under a long-term disability (“LTD”) policy in a manner most beneficial to them, rather than the claimant.  In a recent decision by the Tenth Circuit Court of …

Read moreTenth Circuit Finds that Policy Terms in an ERISA Plan Did Not Unequivocally Grant an ERISA Administrator Discretion to Interpret Plan Terms, Applies De Novo Review

“Own Occupation” Duties in a Long-Term Disability Policy Governed by ERISA: Does a Court Favor Those Listed in the Description of One’s Actual Job, or Those Performed in the National Economy?

“Own Occupation” Duties in a Long-Term Disability Policy Governed by ERISA: Does a Court Favor Those Listed in the Description of One’s Actual Job, or Those Performed in the National Economy? Sometimes a legal dispute comes down to the simple interpretation of the meaning of two words.  The case of Christopher Patterson v. Aetna Life …

Read more“Own Occupation” Duties in a Long-Term Disability Policy Governed by ERISA: Does a Court Favor Those Listed in the Description of One’s Actual Job, or Those Performed in the National Economy?

If You Must Miss Work Two Days a Month Due to a Disabling Condition, Are You Precluded from Working in Any Occupation Under a LTD Policy?

Facing a long-term disability (“LTD”) claim, ERISA plan participants under LTD policies can count on the fact that insurance companies will search for ways to escape payment of the monthly LTD benefits they promised their insureds.  These insurers often point out that insureds continue to work in their occupation between their initial diagnosis and the …

Read moreIf You Must Miss Work Two Days a Month Due to a Disabling Condition, Are You Precluded from Working in Any Occupation Under a LTD Policy?

Court upholds Commissioner’s Contention: A Single Insurance Code Violation Can Constitute Bad Faith Without Evidence of a General Business Practice

Every insurance policy, including disability, life, health or accidental death policies, contains an implied covenant of good faith and fair dealing between the insurance company and the insured. This covenant requires that insurance companies refrain from acting in a way that unreasonably jeopardizes, impairs or interferes with the rights of the insured to receive the …

Read moreCourt upholds Commissioner’s Contention: A Single Insurance Code Violation Can Constitute Bad Faith Without Evidence of a General Business Practice

“Sole Cause” Provisions in Accidental Death and Dismemberment Policies: Are ERISA Claimants Getting a Fair Shake?

According to the Centers for Disease Control, unintentional injury is the leading cause of death among people ages 1 to 44.  For this reason, Accidental Death and Dismemberment (“AD&D”) Insurance should be an essential component of insurance coverage for most families.  As preventative care expands and baby boomers remain active, accidental deaths will likely continue …

Read more“Sole Cause” Provisions in Accidental Death and Dismemberment Policies: Are ERISA Claimants Getting a Fair Shake?

Sitting: If you are Unable to do it, are you Totally Disabled Under a Long-Term Disability Policy?

While most people tend to have a common-sense view of what it means to be disabled, under long-term disability (“LTD”) policies, an insured must satisfy the terms of a disability policy and its specific definitions of “disability” to receive LTD benefits.  Within the first two years of a disability claim, “disability” in a policy is …

Read moreSitting: If you are Unable to do it, are you Totally Disabled Under a Long-Term Disability Policy?

A Recent California Supreme Court Decision Clarifies when an Intentional Act with Unforeseen Results is an Accident under a Liability Policy

Generally, an insured will not receive coverage under a liability policy when they intentionally cause the loss or injury for which they are seeking coverage.  As expected, insurers regularly deny claims when they are able to characterize an insured’s conduct as intentional, even when the damage or injury caused was accidental or not intended by …

Read moreA Recent California Supreme Court Decision Clarifies when an Intentional Act with Unforeseen Results is an Accident under a Liability Policy

Exhaustion of Administrative Remedies in ERISA: The Potential Death Knell of a Disability, Life or Health Insurance Claim

The Employee Retirement Income Security Act of 1974, or ERISA, establishes protections for most employee benefits offered through employer-sponsored benefit plans. ERISA requires that the plan and claims administrators adhere to certain internal procedures, often referred to as “administrative remedies,” when determining a plan participant’s eligibility for benefits. Typically, these administrative remedies include internal appeals …

Read moreExhaustion of Administrative Remedies in ERISA: The Potential Death Knell of a Disability, Life or Health Insurance Claim

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Address: 20321 SW Birch St. Suite 200
Newport Beach, CA 92660

Phone: 800-682-4137

We also have offices in Los Angeles, San Diego and San Francisco.

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