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Tag Archives: long-term disability insurance

Attending Physician’s Certifications of Disability: How Important Are They for Disability Insurance Claims Under ERISA?

Posted in: Disability Insurance, ERISA, Insurance Litigation Blog, Social Security Administration September 14, 2018

Many employees are covered by group short-term disability insurance and/or group long-term disability insurance.  These plans provide benefits to employees who cannot return to work because of illness or injuries that prevent them from performing their work activities.  The Employee Retirement Income Security Act of 1974 (“ERISA”) governs most of these insurance plans.  Unfortunately, sometimes an insured becomes disabled and must support his claim for disability benefits.  The insured’s attending physician typically has examined the insured and determines that he cannot return to work.  The insured will want to use his physicians’ certification of disability to support his disability by submitting it to his insurer.  A common question is:  Must an insurance company accept the treating physician’s opinion regarding the …

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Orange County Lawyer Publishes Article in July 2018 edition by Robert J. McKennon Entitled “Insurers’ Intermediaries: The Implications of Actions Taken by Agents, Employers, and Third-Party Administrators”

Posted in: Accidental Death or Dismemberment, Agent/Broker, Bad Faith, Disability Insurance, ERISA, Health Insurance, Legal Articles, Life Insurance July 13, 2018

In July 2018, The Orange County Bar Association published an article written by Robert J. McKennon and Stephanie L. Talavera of the McKennon Law Group PC in the Orange County Lawyer.  The article addresses the liability implications of the relationship between insurers and various types of intermediaries.  As the article explains, depending on the nature of the relationship between the insurer and others involved in the process, the insurer may be held liable for the actions of those who act as its intermediaries.  The article gives tips on how to make an insurer vicariously liable for the acts of those functioning as intermediaries in the insurance process.

Insurers’ Intermediaries: The Implications of Actions Taken by Agents, Employers and Third-Party Administrators

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How to Fight ERISA Long-Term Disability Claims Denials: The Use of Personal Statements

Posted in: Benefits, Disability Insurance News, ERISA April 02, 2018

Pain is a highly subjective, personal phenomenon. Only the person suffering from pain can adequately describe that pain and how that person is affected by the pain. And we know that one person may be capable of tolerating a completely different threshold of pain when compared to another person. Similarly, reports of fatigue vary widely from person to person. Because of the nature of pain, fatigue and other such disabling symptoms, determining whether subjective complaints render an individual disabled for the purposes of long-term disability benefits necessarily relies on the individual claimant’s personal statement/description. Put another way, the individual must explain what he or she goes through firsthand. Not only does this aid in the insurer’s understanding of the insured’s …

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Robert McKennon Quoted in Super Lawyers' Article: Does Suicide Invalidate an Insurance Claim? It All Depends on the Language in the Policy

Posted in: Insurance Litigation Blog March 10, 2018

Robert J. McKennon, founding shareholder of McKennon Law Group PC, shared his comment for an article discussing important clauses in insurance policies entitled “Does Suicide Invalid an Insurance Claim? It All Depends on the Language in the Policy.” The author of the article, Trevor Kupfer, requested Mr. McKennon’s expertise as to several important clauses in insurance policies, including incontestability clauses, suicide clauses and accidental death and dismemberment clauses. Mr. McKennon is quoted extensively in the article and he discusses some of his cases dealing with the issue of suicide vs. accident. On February 2, 2018, the article was published to the “Super Lawyers” website, a ratings service that recognizes prominent lawyers for high levels of professional achievement. Mr. McKennon, an …

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Court Reinstates Disability Benefits Because Insurer's Vocational Expert Ignored Treating Physicians' Opinions

Posted in: Disability Insurance, Employee Benefits News, ERISA, Life Insurance November 23, 2017

When an insured becomes disabled and incapable of performing the duties of his or her occupation, long-term disability benefits can provide a much-needed form of substitute income. Given the potential importance of these disability insurance benefits, playing an active role in the claims handling process is integral to the success or failure of an insured’s claim. In marshaling medical evidence in support of a long-term disability, insureds often rely on the opinions of their treating physicians and rightfully so, as the support of a treating physician can make or break a claim. However, the support of treating physicians does not equate to automatic approval of benefits. Typically, an insurer will hire its own medical or vocational expert to evaluate a …

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Robert McKennon and Stephanie Talavera Publish Article in the Los Angeles Daily Journal: "Ruling Clears Up Attorney Fees in ERISA Cases"

Posted in: Disability Insurance, Employee Benefits News, ERISA, Life Insurance, News, News Blog November 10, 2017

Unlike a state law claim for benefits under an individual insurance policy, an ERISA claim generally limits recovery to benefits due under the plan: prejudgment interest, declaratory or equitable (non-monetary) relief and attorneys’ fees. Accordingly, looming attorneys’ fees serve as an important financial disincentive for an ERISA plan administrator’s misconduct. In today’s edition of the Los Angeles Daily Journal, Robert J. McKennon and Stephanie L. Talavera of the McKennon Law Group PC discuss the importance of ERISA attorneys’ fees and how a recent case positively impacts the ability to recover those fees. In a column entitled “Ruling Clears Up Attorney Fees in ERISA Cases,” we evaluate the effect of the new Ninth Circuit Court of Appeals case, Micha v. Sun

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The Hartford Agrees to Purchase Aetna's Group Disability Insurance and Group Life Insurance Business

Posted in: Disability Insurance, Disability Insurance News, ERISA, Group Plans, Life Insurance, News Blog November 08, 2017

In a deal between two of the country’s largest disability insurers, The Hartford agreed to purchase Aetna Life Insurance Company’s group life insurance and disability insurance business for $1.45 billion. After the purchase, which is expected to close before the end of 2017, The Hartford will be the second largest group life and disability insurer, with 20 million customers insured by the combined business. A vast majority of these customers’ claims will be governed by ERISA.

According to media reports, The Hartford’s purchase of Aetna’s group life and disability insurance was designed to strengthen the company’s business among mid-sized companies, and take advantage of Aetna’s superior technology infrastructure. Aetna, in turn, will focus on its race with rival health insurance …

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Attorney Robert J. McKennon Educates Policyholders on ERISA and Disability Insurance Claims

Posted in: Disability Insurance News, Employee Benefits News, ERISA, Life Insurance October 27, 2017

When a disability insurance claim is denied, the process of challenging that wrongful denial can be daunting. At McKennon Law Group PC, we represent policyholders in their insurance disputes and help guide our clients through the complex insurance claims process. We pride ourselves on the relationships we build with our clients and work hard to ensure that our clients understand the status of their matter every step of the way.

As part of our firm’s dedication to serving insureds, Robert J. McKennon, the firm’s founder, answered some of the most frequently asked questions regarding disability insurance benefits and the Employee Retirement Income Security Act, or ERISA. In the Q&A, Mr. McKennon briefly explains the role of ERISA, the body of …

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Robert McKennon and Stephanie Talavera Publish Article in the Los Angeles Daily Journal: "An Agent of the Insurer."

Posted in: Disability Insurance, Employee Benefits News, ERISA, Life Insurance October 11, 2017

In the October 9, 2017 Los Angeles Daily Journal, Robert J. McKennon and Stephanie L. Talavera of the McKennon Law Group PC published a column entitled “An Agent of the Insurer,” covering a very important new Ninth Circuit Court of Appeals case, Salyers v. Metro. Life Ins. Co., 2017 DJDAR 9291 (Sept. 20, 2017). The article details the case’s key holdings, as it establishes federal ERISA common law rules that follow California’s employer-friendly rules. The decision provides a solid foundation for future ERISA plan participants and beneficiaries to vigorously attack ERISA coverage denials on theories of estoppel, waiver and breach of fiduciary duty.

The article is posted below with the permission of the Los Angeles Daily Journal.

By Robert

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Robert McKennon and Stephanie Talavera Publish Article in the Los Angeles Daily Journal: "An Agent of the Insurer."

Posted in: News Blog October 10, 2017

In the October 9, 2017 Los Angeles Daily Journal, Robert J. McKennon and Stephanie L. Talavera of the McKennon Law Group PC published a column entitled “An Agent of the Insurer,” covering a very important new Ninth Circuit Court of Appeals case, Salyers v. Metro. Life Ins. Co., 2017 DJDAR 9291 (Sept. 20, 2017). The article details the case’s key holdings, as it establishes federal ERISA common law rules that follow California’s employer-friendly rules. The decision provides a solid foundation for future ERISA plan participants and beneficiaries to vigorously attack ERISA coverage denials on theories of estoppel, waiver and breach of fiduciary duty.…

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