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Tag Archives: Ninth Circuit

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

Posted in: Benefits, Disability Insurance News, ERISA February 26, 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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Ninth Circuit Affirms MLG’s Six-Figure Judgment in a Disability Suit Filed Against Sun Life

Posted in: Abuse of Discretion, Administrative Record, Case Updates, Conflict of Interest, Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog April 29, 2015

On April 22, 2015, the United States Court of Appeals for the Ninth Circuit issued a decision affirming the district court’s decision to award McKennon Law Group PC’s client, an attorney (“insured”), his past-due ERISA plan benefits, as well as attorneys’ fees, costs and interest against Sun Life & Health Insurance Company in connection with his short-term and long-term disability insurance claim. …

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The Ninth Circuit Amends Opinion in Du v. Allstate removing policyholder friendly language

Posted in: Auto Insurance, Case Updates, General Liablity, Insurance Bad Faith October 15, 2012

We recently wrote about a policyholder friendly opinion by the Ninth Circuit Court of Appeals that seemingly held that an insurer’s duty of good faith and fair dealing, which is implied in every contract of insurance, may be violated by the insurer’s failure to attempt to effectuate a settlement within policy limits after liability of its insured has become reasonably clear, even without a policy limits settlement demand.  In other words, the court held that a demand within policy limits was not an element of a bad faith failure to settle claim.  The Ninth Circuit, on October 5, 2012, issued an amended opinion deleting this language and leaving open the questions: 1) whether the duty to settle can be breached …

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Equitable Relief in the Ninth Circuit Just Got Better for Consumers

Posted in: Case Updates, Disability Insurance, Disability Insurance News, Equitable Relief, ERISA, Insurance Litigation Blog July 11, 2012

The Wednesday July 11, 2012 edition of the Los Angeles Daily Journal featured Robert McKennon’s and Scott Calvert’s article entitled: “Equitable Relief in the Ninth Circuit Just Got Better for Consumers.”  In it, Mr. McKennon and Mr. Calvert discuss two important Ninth Circuit rulings allowing certain equitable relief to ERISA plan participants that have definite pro-consumer holdings.  The article is posted below with the permission of the Daily Journal.

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Ninth Circuit Clarifies ERISA's Full and Fair Review Standard by Imposing New Requirements on Plan Administrators in Salomaa Case

Posted in: Abuse of Discretion, Disability Insurance, Disability Insurance News, ERISA, Insurance Litigation Blog March 17, 2011

ERISA requires that an administrator provide a claimant with a “full and fair” review of a denial decision.  In a recent ruling entitled Salomaa v. Honda Long Term Disability Plan, __ F.3d __, 2011 U.S. App. LEXIS 4386 (9th Cir. Cal. Mar. 7, 2011) the Ninth Circuit Court of Appeals imposed a new requirement that an insurer must meet in order to conduct a full and fair review.  Specifically, an administrator must provide a claimant with copies of the internal medical reports it generated and relied upon when making the decision when it denies a claim.  The Ninth Circuit held that the failure to provide the claimant with copies of the medical reports, and also to sufficiently explain what …

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