Breach of Fiduciary Duty under ERISA: Making the Insurer or Plan Administrator Responsible for their actions towards a Plan’s Participants and Beneficiaries

Posted in: Accidental Death or Dismemberment, Equitable Relief, ERISA, Fiduciary Duty, Insurance Litigation Blog, Life Insurance, Waiver & Estoppel November 06, 2018

In a previous blog, we addressed the doctrines of equitable estoppel and waiver when the Employee Retirement Income Security Act of 1974 (“ERISA”) governs their insurance or pension plan.  As we explained, both doctrines provide an insured with methods of forcing an insurance company to honor its word and previous conduct.  However, insureds often have difficulty invoking the doctrines.  ERISA governs a wide variety of plans that provide life insurance, disability insurance, accidental death and dismemberment insurance and pension benefits.  Given the challenges of invoking equitable estoppel and waiver in the ERISA context, do plan participants and their beneficiaries have other ERISA specific tools to force insurers to honor their word and previous conduct?  Luckily, they do.  A lawsuit …

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Los Angeles Daily Journal Publishes Article on October 26, 2018 by Robert McKennon Entitled “Court says insurer can’t dodge coverage through ‘technical escape hatch’”

Posted in: Accidental Death or Dismemberment, Disability Insurance, ERISA, Insurance Litigation Blog, Legal Articles, Life Insurance, News October 29, 2018

In the October 26, 2018 issue of the Los Angeles Daily Journal, the Daily Journal published an article written by the McKennon Law Group’s Robert J. McKennon.  The article addresses a recent case by the California Court of Appeal, which held that the notice-prejudice rule precluded the denial of life insurance benefits based upon the insured’s failure to give timely notice of disability as required under a disability premium waiver provision in the life insurance policy.  Insurers often attempt to argue that a technical violation of the notice requirements voids their claim where there exists no prejudice to them.  This recent opinion helps to reinforce the notice-prejudice rule in California and helps to protect insureds.

This article is posted with …

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Waiver and Estoppel in the Ninth Circuit Post Salyers v. Metropolitan Life Ins. Co.

Posted in: Equitable Relief, ERISA, Insurance Litigation Blog, Life Insurance, Waiver & Estoppel October 16, 2018

Waiver and equitable estoppel serve as some of the legal systems’ fundamental checks on the fairness of a party’s actions.  Both doctrines serve to prevent an individuals and insurers from performing actions contradictory to what they have previously guaranteed or established via their conduct.  “A waiver occurs when a party intentionally relinquishes a right or when that party’s acts are so inconsistent with an intent to enforce the right as to induce a reasonable belief that such right has been relinquished.”  Salyers v. Metro. Life Ins. Co., 871 F.3d 934, 938 (9th Cir. 2017) (internal quotations omitted).  Equitable estoppel “holds the [individual] to what it had promised and operates to place the person entitled to its benefit in the …

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

Posted in: Bad Faith, Insurance Bad Faith, Insurance Commissioner, Insurance Litigation Blog, Policy Interpretation, Regulations, Unfair Business Practices/Unfair Competition October 02, 2018

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 way that unreasonably jeopardizes, impairs or interferes with the rights of the insured to receive the benefit of the insurance contract.  The Unfair Insurance Practices Act (California Insurance Code Sections 790, et seq., “UIPA”) was enacted to regulate the business of insurance by defining and prohibiting practices which constitute unfair methods of competition or unfair or deceptive acts or practices.

California Insurance Code Section 790.03(h) (“Section 790.03(h)”) enumerates a list of sixteen specific unfair claims settlement practices that insurance companies are …

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McKennon Law Group PC Insurance Litigation Blog Ranked as Top 50 Insurance Law Blog in the U.S.

Posted in: Disability Insurance, ERISA, Insurance Litigation Blog, Legal Articles, News September 26, 2018

On September 21, 2018, Feedspot created a list of the Top 50 Insurance Law Blogs, News Websites and Newsletters to Follow in 2018.  McKennon Law Group PC | Insurance Litigation Blog was selected by the panelists at Feedspot as one of the Top 50 Insurance Law Blogs and was selected the 13th overall Law Blog among thousands on the internet.  Feedspot ranked the Insurance Law Blogs on the web using Google reputation and search ranking, influence and popularity on social media, quality and consistency of posts and Feedspot’s own editorial team and expert review.  The article is posted below:

This article is posted with the permission of Feedpost.  Sep. 21, 2018.

<https://blog.feedspot.com/insurance_law_blogs/>

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McKennon Law Group PC’s Trial Victory Included in Los Angeles Daily Journal’s September 21, 2018 List of Top Verdicts & Settlements

Posted in: Disability Insurance, ERISA, Insurance Litigation Blog, Legal Articles, News September 25, 2018

In the September 21, 2018 issue of the Los Angeles Daily Journal, the Daily Journal published a list of its top “Verdicts & Settlements,” which included the McKennon Law Group’s case of Brian Wright v. AON Hewitt Absence Management LLC, et al.  The judgment in Mr. Wright’s favor was rated as the third highest award of damages for a plaintiff for the period of time covered.  The McKennon Law Group PC represented Mr. Wright in a dispute over the payment of short-term and long-term disability benefits.  We won this ERISA case at trial and our client was awarded all of his disability insurance benefits, attorney’s fees, costs and interest.  The list includes a summary of the case and the …

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When Guarding the Henhouse, Some Foxes Go Rogue: When an Insurer’s Conflict of Interest Factors into Administrating Group Long-Term Disability ERISA Plans

Posted in: Abuse of Discretion, Accidental Death or Dismemberment, Conflict of Interest, Disability Insurance, Disability Insurance News, ERISA, Health Insurance, Insurance Litigation Blog, Life Insurance, News July 25, 2018

Few Americans can retire on their savings alone.  Many workers participate in an employee benefits plans, which serve to provide financial security in case of disability or retirement.  In the case of insurers that decide who qualifies for life, health and disability insurance benefits, there exists a major concern about the significant conflict of interest that exists when these insurers make these decisions and also pay for these benefits.  Will these insurers exalt their own interests of bottom line profitability over the interests of ERISA plan participants and beneficiaries who file claims for life, health and disability benefits? It is not a leap of logic that this conflict of interest results in insurance companies wrongfully denying ERISA benefit claims.

In

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Opportunistic Rescission: When Do Insurers Waive their Right to Rescind an Insurance Policy?

Posted in: Accidental Death or Dismemberment, Agent/Broker, Disability Insurance, Disability Insurance News, Health Insurance, Insurance Litigation Blog, Life Insurance, News, Waiver & Estoppel July 12, 2018

All too often, we see insurance companies deny insurance claims by attempting to opportunistically rescind insurance policies. This practice has become more prevalent in recent years as insurers look for ways to deny insurance claims.

Anyone who has purchased a disability, life or health insurance policy is likely familiar with the significant paperwork involved in the insurance application process. The paperwork includes policy notices, policy applications, supplemental policy applications, personal history questionnaires, policy warnings, medical examination documents, etc. These will include numerous and detailed questions relevant (and often not so relevant) to the risk being insured. An insurance agent or broker will ask questions on the policy application and often additional questions not on the application. Only after the applicant …

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Ninth Circuit Interprets the Health Parity Act in Favor of Insureds Seeking Health Insurance Benefits

Posted in: ERISA, Health Insurance, Insurance Litigation Blog, Legal Articles, News June 14, 2018

Insurance companies often attempt to provide different levels of benefits for the treatment of physical injuries and mental health issues in the same policy.  Mental health parity describes the equal treatment of mental health conditions and non-mental health conditions in insurance plans. When a plan or policy has parity, it means that if a covered person is provided unlimited doctor visits for a chronic condition like diabetes then that person must offer unlimited visits for a mental health condition, such as depression or schizophrenia.  Under federal law, health insurance plans must have parity in benefits.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, 29 U.S.C. § 1185a, requires that if a plan provides …

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Los Angeles Daily Journal Publishes Article on May 24, 2018 by Robert McKennon Entitled “Preexisting Condition Doesn’t Preclude Coverage”

Posted in: Accidental Death or Dismemberment, Disability Insurance, ERISA, Insurance Litigation Blog, Legal Articles, News May 28, 2018

In the May 24, 2018 issue of the Los Angeles Daily Journal, the Daily Journal published an article written by the McKennon Law Group’s Robert J. McKennon.  The article addresses a recent case by the Ninth Circuit Court of Appeals, which held that if an insured with a preexisting medical condition suffers from an accidental injury, the insured is not precluded from recovery under an accidental death and dismemberment policy if the preexisting condition did not substantially contribute to the injury.  Insurers often attempt to use preexisting conditions as an excuse to deny payment under AD&D policies.  This recent Ninth Circuit opinion helps insureds by making it clear that a preexisting condition’s slight contribution to an injury is insufficient to …

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