9th Circuit puts final nail in coffin for discretionary clauses in insurer-funded ERISA plans

Posted in: Abuse of Discretion, Case Updates, De Novo Review, Disability Insurance, Disability Insurance News, ERISA, Health Insurance, Insurance Litigation Blog, Life Insurance, Policy Interpretation, Preemption, Standard of Review May 24, 2017

Disability and life insurers frequently include clauses in their insurance policies affording them complete discretion to decide whether a claim has merit.  The clauses usually state the insurer has total discretion to decide whether the claimant is eligible for the …

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Good News for Policyholders: The Insurance Commissioner has Broad Authority to Regulate Insurers

Posted in: Case Updates, Disability Insurance, Disability Insurance News, Insurance Litigation Blog January 27, 2017

We all know that insurance companies are good at trying to find any way possible to deny claims, whether they be long-term disability claims, life insurance claims, health insurance claims or homeowner’s claims.  To curtail their ability to do so, …

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Insureds May Still Have a Claim for Insurance Bad Faith Even If Their Insurer Offered to Pay the Policy Limits

Posted in: Bad Faith, Case Updates, Commercial General Liability Insurance, Duty to Settle, Insurance Bad Faith, Insurance Litigation Blog December 13, 2016

Under California law, an insurer has an obligation to, among other things, make reasonable efforts to settle a third party’s lawsuit against an insured.  As a recent decision rendered by the California Court of Appeals illustrates, “reasonable efforts” entail more …

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Have “Quack” Medical Reviewers Caused Denial of Your Long-Term Disability Claim? California Court of Appeal Berates Insurance Company for Controlling Medical Peer Reviews

Posted in: Bad Faith, Case Updates, Disability Insurance News, Expert Testimony, Health Insurance, Insurance Litigation Blog, Punitive Damages December 13, 2016

During their Presidential election campaigns, Donald Trump and Hillary Clinton spotlighted for America flaws in our criminal justice system.  They raised questions about whether the criminal probe into Ms. Clinton’s private email server was handled honestly or politically.  Conservatives bitterly …

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Federal Court Criticizes Long-Term Disability Insurer for “Paper Reviews” and Dismissing SSA Award

Posted in: Case Updates, Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog October 07, 2016

Were you denied benefits by your group long-term disability insurer without the insurance company’s doctor examining you in-person?  Did your insurer deny your claim even though the Social Security Administration concluded you are disabled?  If so, the McKennon Law Group …

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Ninth Circuit Affirms Rule that Ambiguous Policy Terms Must Be Construed Against Insurer in ERISA Disability Insurance Cases

Posted in: Case Updates, Disability Insurance, ERISA, Insurance Litigation Blog, Policy Interpretation July 06, 2016

The “reasonable expectations of the insured” doctrine has been around for decades in California.  The state Supreme Court started toying with rules that became its foundation after the turn of the century.  See Pac. Heating & Ventilating Co. v. Williamsburgh

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Group Life Insurer’s Literal Policy Interpretation Penalizing Insured for not working on Paid Holiday Rejected

Posted in: Breach of Contract, Case Updates, Life Insurance, Policy Interpretation September 08, 2015

Group life insurance policies often have confusing language about when they become effective. A trial court recently interpreted one to mean that the policy had not become effective to a full-time employee, though he was already eligible for the coverage, …

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