Court Finds Regional Claims Administrator Qualifies as a “Managing Agent” of an Insurance Company, Justifying an Award of Punitive Damages

Posted in: Auto Insurance, Bad Faith, Breach of Contract, Duty to Settle, Insurance Litigation Blog, Punitive Damages May 29, 2019

When insurance companies, including those offering disability, life, health or accidental death policies, engage in conduct that is sufficiently egregious, a court may award punitive damages against the insurance company.  California Civil Code Section 3294 (“Section 3294”) provides that where the defendant is guilty of oppression, fraud or malice, the plaintiff may recover punitive damages for the sake of example and by way of punishing the defendant.  If the defendant is a corporation, such as an insurance company, the defendant is liable for punitive damages if the act of oppression, fraud or malice was authorized or ratified by an officer, director or managing agent of the corporation or if the officer, director or managing agent was personally guilty of such …

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Robert J. McKennon and Joseph S. McMillen to Present “ERISA and California Bad Faith Litigation, Hot Topics and Trends in Disability, Life and Health Insurance Claims” Seminar for OCBA on June 13, 2019

Posted in: Insurance Litigation Blog, News Blog May 17, 2019

McKennon Law Group PC’s, founding and managing shareholder, Robert J. McKennon and senior attorney, Joseph S. McMillen, will speak on an MCLE panel for the Orange County Bar Association on June 13, 2019, discussing “ERISA and California Bad Faith Litigation, Hot Topics and Trends in Disability, Life and Health Insurance Claims.”  Mr. McKennon has been practicing in the areas of ERISA, life, disability and health bad faith insurance litigation and business litigation for 33 years.  Mr. McMillen has been practicing in the areas of insurance and bad faith litigation for two decades, including numerous ERISA-governed disputes over disability and life insurance benefits.  The MCLE event is scheduled to take place at the OCBA headquarters from 12:15 P.M. – 1:30 P.M. …

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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

Posted in: Disability Insurance, ERISA, Insurance Litigation Blog, Policy Interpretation, Standard of Review May 17, 2019

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 Appeals, Hodges v. Life Insurance Company of North America, 920 F.3d 669 (10th Cir. 2019), the court addressed the ability of insurance companies such as Life Insurance Company of North America (“LINA”) from interpreting policy language that may determine the level of benefits payable to a claimant.

In Hodges, the Tenth Circuit Court of Appeals affirmed the ruling of the district court that …

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The Basics of an ERISA Life, Health and Disability Insurance Claim – Part Three: Procedural and Practical Considerations to an ERISA Claim

Posted in: ERISA April 22, 2019

In this several part Blog Series entitled The Basics of an ERISA Life, Health and Disability Insurance Claim, we discuss the basics of an ERISA life, health, accidental death and dismemberment and disability claim, from navigating a claim, handling a claim denial and through preparing a case for litigation.  In Part Three of this Series, we discuss procedural considerations to an ERISA claim, as well as deadlines and timeframes to carefully monitor.

When first reviewing a potential ERISA matter, it is crucial to first determine the procedural history of your client’s claim and whether there have been any denials.  Most denial letters in ERISA cases set forth specific deadlines to respond to an appeal.  In fact, the Department of …

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“Own Occupation” Duties in a Long-Term Disability Policy Governed by ERISA: Does a Court Consider Those that Relate to One’s Actual Job or as Performed in the National Economy?

Posted in: Disability Insurance News, Insurance Litigation Blog April 12, 2019

“Own Occupation” Duties in a Long-Term Disability Policy Governed by ERISA: Does a Court Consider Those that Relate to One’s Actual Job or as Performed in the National Economy?   

Sometimes a legal dispute comes down to the simple interpretation of the meaning of two words.  In the case of Christopher Patterson v. Aetna Life Insurance Company, 2019 WL 479209 (3d Cir. February 7, 2019) is such a case.  There, the Third Circuit Court of Appeals upheld summary judgment in favor of the plaintiff, ruling that, as used in plaintiff’s long-term disability policy underwritten by Aetna under ERISA, the plain meaning of “own occupation” is the job duties related to one’s actual job, as opposed to some generalized “national economy” definition …

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The Basics of an ERISA Life, Health and Disability Insurance Claim – Part Two: Plan and Claims Administrators

Posted in: ERISA, Insurance Litigation Blog April 01, 2019

In this several part Blog Series entitled The Basics of an ERISA Life, Health and Disability Insurance Claim, we discuss the basics of an ERISA life, health and disability claim, from navigating a claim, handling a claim denial and through preparing a case for litigation.  In Part Two of this Series, we discuss the roles of various Administrators, the administrative record and the laws requiring Administrators to provide their records to a claimant.

Two different entities manage an ERISA plan, the Plan Administrator and the Claims Administrator.  Often times, the two roles are performed by different entities.  The Plan Administrator manages and sponsors the plan and must ensure that the plan complies with applicable regulations.  The Plan Administrator is …

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Ten Things to Consider and Look For in Your ERISA Life and/or Accidental Death and Dismemberment (AD&D) Insurance Plans When Selecting Benefits or You Want to File a Claim

Posted in: Accidental Death or Dismemberment, Administrative Record, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Life Insurance, Statute of Limitations March 18, 2019

1. Obtain a full copy of your plan. The full plan will not typically be a benefit summary or a print-out from a website. It will be fairly long and many definitions and it will recite your ERISA plan terms, policies and procedures for filing a life insurance or AD&D claim and handling the claim, claim denials, appeals of claim denials, etc.  The claims administrator will likely not have a copy of the full plan.  You can request a copy of the full plan from your Employer’s Human Resources department or often from the claims administrator (the insurer or third-party administrator).

2. Read the plan. Your plan document controls the rights and obligations of the parties, including all plan participants …

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Ten Things to Consider and Look For in Your ERISA Short-Term and Long-Term Disability Plans When Selecting Benefits or You Want to File a Claim

Posted in: Administrative Record, Disability Insurance, ERISA, Insurance Litigation Blog, Insurance Questions and Concepts, Statute of Limitations February 28, 2019

1. Obtain a full copy of your plan and administrative record. The full plan will not typically be a benefit summary or a print-out from a website.  It will be fairly long and many definitions and it will recite your ERISA plan terms, policies and procedures for filing a claim and handling the claim, claim denials, appeals of claim denials, etc.  The claims administrator will likely not have a copy of the full plan.  You can request a copy of the full plan from your Employer’s Human Resources department or often from the claims administrator (the insurer or third-party administrator).  You can request a copy of the administrative record from the claims administrator, which is often an insurance company such …

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Robert J. McKennon Recognized as 2019 "Super Lawyer – Insurance Coverage"

Posted in: Insurance Litigation Blog, News Blog February 13, 2019

McKennon Law Group PC is proud to announce that its founding shareholder Robert J. McKennon has been recognized as one of Southern California’s “Super Lawyers” and appears in the 2019 edition of Southern California Super Lawyers magazine published in January 2019. Mr. McKennon has received this prestigious designation every year since 2011. Mr. McKennon was voted by his peers for this award and he was recognized for his excellence in representing his clients as an insurance claims denial attorney, especially with respect to his work representing life, health and disability policyholder clients.  Each year, Super Lawyers magazine, which is published in all 50 states and reaches more than 14 million readers, names attorneys in each state who attain a high …

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USA Today Publishes Article—Why millennials should consider disability insurance

Posted in: Disability Insurance, Insurance Litigation Blog February 08, 2019

On January 29, 2019, USA Today published an article, “Why millennials should consider disability insurance,” by Robert Powell.  The article argues for the importance of purchasing disability insurance at a young age, since most insureds are left with the financial strain of not having a stable income stream after disability.  These insureds often never consider purchasing disability insurance, or think they have enough coverage.  At McKennon Law Group PC, we see the impact of the denials of our client’s benefits every day, and fight to overturn the denial decisions of insurance claims our clients expected insurance companies to pay upon becoming disabled.  As we have seen, purchasing additional private disability insurance can prove to be crucial.

The article describes how …

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