Robert McKennon Publishes Article: Ninth Circuit: 'Independent' Physicians may Favor Insurers

Posted in: Abuse of Discretion, ERISA, Insurance Litigation Blog, Legal Articles, Standard of Review September 08, 2016

In the September 8, 2016 edition of the Los Angeles Daily Journal, Robert McKennon of the McKennon Law Group published an article regarding the use of so-called “independent” physicians used by insurance companies as a pretense to deny valid claims.  …

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With Discretionary Language Even Barred in Self-Funded ERISA Plans, is This the Death of The Abuse of Discretion Standard of Review In California?

Posted in: Abuse of Discretion, De Novo Review, Disability Insurance News, ERISA, Standard of Review October 12, 2015

Recently, we explained that District Courts within the state of California, applying California Insurance Code section 10110.6, ruled that, even if an insurance Plan contains language giving discretion to a claim administrator, that language is unenforceable, and de novo is …

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ERISA Disability Insurance Claimants Take Note – Discovery Is Allowed In De Novo Review Cases

Posted in: Abuse of Discretion, De Novo Review, Disability Insurance News, ERISA, Standard of Review September 14, 2015

Well-intentioned policymakers enacted the Employee Retirement Income Security Act of 1974 (“ERISA”) over forty years ago to provide for the protection of participants’ employee benefits in part by establishing a uniform set of rules to ensure efficient proceedings.  One of …

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Insurers Do No Have Discretionary Authority, Absent Clear Language in Official Plan Documents

Posted in: Abuse of Discretion, Administrative Record, Case Updates, De Novo Review, Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Policy Interpretation, Standard of Review April 30, 2015

In actions brought under the Employee Retirement Income Security Act of 1974 (“ERISA”), two roads diverge in federal court—and the court’s choice regarding the applicable standard of review can make all the difference in the scope of permissible evidence.  If …

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Third-Party ERISA Administrator Abused Discretion by Denying Medical Coverage: A Tale of What Not to Do

Posted in: Abuse of Discretion, Administrative Record, Conflict of Interest, ERISA, Fiduciary Duty, Health Insurance, Standard of Review September 16, 2014

Sometimes an administrator so unashamedly abuses its discretion in handling an insurance claim that its actions constitute a textbook example of “what not to do” for other administrators and the ensuing decision provides a clear illustration of how courts apply …

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California District Court Rules That a Treating Physician's Observations are "More Persuasive" Than a Paper Reviewer's Contrary Opinions

Posted in: Case Updates, Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog, Standard of Review February 13, 2014

When reviewing a claim for disability insurance, insurers and other claim administrators often rely on the opinions of paid physicians to support their improper denial decisions.  For example, a disability insurance company will hire a doctor to conduct a “paper …

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McKennon Law Group Wins Disability Insurance Lawsuit Against Sun Life And Health Insurance Company Following Trial

Posted in: Abuse of Discretion, Conflict of Interest, Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog, News, Standard of Review December 11, 2012

On November 27, 2012, following a trial before Judge Cormac J. Carney of the United States Federal District Court for the Central District of California, Robert J. McKennon and Scott E. Calvert of the McKennon Law Group secured a victory …

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In an ERISA Case, What Actions Will Reduce the Level of Discretion Afforded the Claims Administrator/Insurer?

Posted in: Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Standard of Review January 24, 2012

This article continues our series of articles answering basic questions about insurance law and the Employee Retirement Income Security Act of 1974 (commonly referred to as “ERISA”).  This one addresses:  In a lawsuit governed by ERISA, what actions taken by …

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California Bans the Inclusion of Policy Provisions Giving Insurance Companies Discretionary Authority to Decide Claims

Posted in: Disability Insurance, Disability Insurance News, ERISA, Insurance Commissioner, Insurance Litigation Blog, Legislation, News, Standard of Review October 07, 2011

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 unenforceable in new or renewed policies.  SB 621 was authored …

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