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Life, Health, Disability and ERISA
Our attorneys possess comprehensive knowledge of the complexities that frequently arise in life, health, and disability benefits litigation. We are adept at counseling clients on issues arising from overlay of the Employee Retirement and Income Security Act ("ERISA"). We aggressively defend insurers and plan administrators in state and federal courts throughout the United States. As part of our Best Practices philosophy, our attorneys maintain current awareness of court decisions throughout the nation. More than many other areas of law, life, health, and disability decisions in one jurisdiction or Federal Circuit are likely to have spill-over effect into others. Staying abreast is especially critical for plan and claim administrators with multiple similar claims in different jurisdictions.
ERISA EXPERIENCE
Our attorneys have a heightened appreciation of the nuances associated with defending employee benefits claims under ERISA. This includes:
- Proactive and prompt removal of ERISA cases to the federal courts
- Attention to evolving issues concerning ERISA preemption, including preventing claims of estoppel, waiver, bad faith, fraud, etc.
- Ensuring the proper confines of discovery, including limitation to the administrative record and limitation of discovery against an insurer or carrier regarding its claims process
- Aggressive motion practice to dismiss common law claims and preclude experts
LIFE INSURANCE KNOWLEDGE
Our attorneys have experience with all life insurance issues. Some recent claims include:
- Whether a death was "accidental"
- Contestability, fraud, and material misrepresentation, including foreign death schemes
- Policy cancellation issues
- Unique beneficiary issues
HEALTH INSURANCE FOCUS
Our attorneys focus on the details of a matter, while keeping focus of the "big" picture in order to achieve results. Recent health insurance matters handled successfully include:
- Disputes over payor submissions deadlines and third-party billing
- Health insurance and provider audits
- HIPPA compliance issues and litigation
- Healthcare subrogation and third-party lien disputes
- Billing agent errors and omissions
- Mandatory insurance reporting to CMS
DISABILITY RESULTS
Our attorneys know that results matter. Recent results achieved in disability matters include:
- Successfully defeating challenges to discretionary clause language
- A determination that benefits are limited to an "own occupation" period as opposed to "any occupation"
- Resolving disputes among overlapping disability policies
- Litigation over a plan conflict of interest affecting the standard of review
- Limiting discovery to the administrative record
For more information about the Global Insurance Services Group at Goldberg Segalla LLP, please contact one of the practice group Co-Chairs:
^ BACK TO INSURANCE PRACTICE GROUPS
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