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

On Behalf of | Sep 4, 2019 | Appeals, ERISA, Firm News, Insurance Litigation Blog, Policy Interpretation

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...

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

On Behalf of | May 17, 2019 | Disability Insurance, ERISA, ERISA - Standard of Review, Firm News, Insurance Litigation Blog, Policy Interpretation

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,...

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?

On Behalf of | Dec 19, 2018 | Disability Insurance, ERISA, Firm News, Insurance Litigation Blog, Policy Interpretation

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...

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

On Behalf of | Oct 2, 2018 | Bad Faith, Firm News, Insurance Bad Faith, Insurance Commissioner, Insurance Litigation Blog, Policy Interpretation, Regulations, Unfair Business Practices/Unfair Competition

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...

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

On Behalf of | Aug 22, 2018 | Accidental Death or Dismemberment, ERISA, Firm News, Insurance Litigation Blog, Policy Interpretation

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...

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

On Behalf of | Aug 3, 2018 | Disability Insurance News, ERISA, Firm News, Insurance Litigation Blog, Policy Interpretation

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...

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

On Behalf of | Jan 6, 2018 | Disability Insurance News, ERISA, Firm News, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation

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...

Cohorst v. Anthem: When Does Waiver Apply under ERISA?

On Behalf of | Dec 26, 2017 | Disability Insurance News, ERISA, Firm News, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation

The Employee Retirement Income Security Act of 1974, or ERISA, governs most employer-sponsored benefit plans.  ERISA establishes protections for employees in the administration of their employer-sponsored benefits, requiring that the administrator adhere to certain...

When the Clock is Ticking: The Interplay of the Contractual Limitations Period and the Statute of Limitations in a Disability Insurance Case

On Behalf of | Dec 26, 2017 | Disability Insurance, Disability Insurance News, ERISA, ERISA - Statute of Limitations, Firm News, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation

The Employee Retirement Income Security Act of 1974, otherwise known as ERISA, governs most employer-sponsored benefit plans, including short and long-term disability benefits, life benefits, accidental death and dismemberment benefits and others.  ERISA was enacted...

Top 5 Issues to Keep in Mind When Litigating ERISA Claims

On Behalf of | May 28, 2017 | Disability Insurance, Disability Insurance News, ERISA, ERISA - Statute of Limitations, Firm News, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation

The McKennon Law Group PC periodically publishes articles on its California Insurance Litigation Blog and Disability Insurance News that deal with frequently asked questions in the insurance bad faith, life insurance, long-term disability insurance, annuities,...