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Disability Insurance Blog
California Bans the Inclusion of Policy Provisions Giving Insurance Companies Discretionary Authority to Decide Claims
In a major victory for consumers, Governor Jerry Brown signed a bill that makes discretionary clauses – typically contained in ERISA-governed life, health and disability insurance policies/ERISA plans void and…
Failure by ERISA Administrator to Comply With Its Duties of Proper Notification and Review May Result in Its Failure to Assert the Statute of Limitations
Recently, the Ninth Circuit Court of Appeals ruled that an ERISA administrator must make a “clear and continuing repudiation” of a claim, in compliance with its duties of proper notification…
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…
An Insurance Company Acting as a Claims Administrator is Again a Proper Defendant in an ERISA Suit for Benefits
The Ninth Circuit has reversed itself and ruled that insurance companies that make claim decisions or are responsible for paying benefits can serve as defendants in ERISA actions for benefits…
What are the Available Remedies Against an Insurance Company That Has Acted in Bad Faith?
This article will be the second in a series of articles by McKennon Law Group PC addressing and answering basic questions concerning insurance law. This one addresses: What are the…
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…
Exhaustion of Administrative Remedies Under ERISA Not Required If Exhaustion Would Have Been Futile
Terrance Burnett was eligible for short-term disability (“STD”) benefits and long-term disability (“LTD”) benefits through employee welfare benefit plans funded by his employer, The Raytheon Company, and administered by Metropolitan…
Fighting An Insurance Claim Denial Will Often Pay Off
It will not be surprising to many readers of this blog that insurance companies often deny life insurance, health insurance and disability insurance claims. Many times, insurance companies are wrong…
Ninth Circuit Clarifies ERISA’s Full and Fair Review Standard by Imposing New Requirements on Plan Administrators in Salomaa Case
ERISA requires that an administrator provide a claimant with a “full and fair” review of a denial decision. In a recent ruling entitled Salomaa v. Honda Long Term Disability Plan,…
Dental Hygienist Wins Large Jury Verdict in Disability Insurance Lawsuit
In 1996, Plaintiff Laura Kieffer developed carpal tunnel syndrome and severe cervical pain which forced her to stop working as a dental hygienist. Thereafter, Kieffer started receiving disability payments under…
