July 13, 2010

COURT ORDERS DISCOVERY IN LONG TERM DISABILITY ERISA CASE

The Eastern District of Michigan federal court recently granted my motion for discovery in a long term disability insurance ERISA case without requiring a predicate showing.

In Back v Hartford I had submitted a limited number of questions to Hartford Insurance Company to try and investigate any potential bias on the part of Hartford and the doctors it hired to review the records. Hartford objected and refused to answer a single question. We filed a motion to compel which the Court granted with one small exception.

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June 29, 2010

SMDA Partner attends ACI-Disability Insurance Seminar

SMDA Partner, Patrick Derkacz, attended the 13th ACI National Advanced Forum on Litigating Disability Insurance claims held in historic Boston last week. This seminar was two solid days of presentations and discussions with the countries leading Disability Insurance Litigation attorneys. It was a great opportunity to discuss the latest developing trends and caselaw in this niche area of practice, not to mention the killer crabcakes at Legal Seafood on the edge of Boston Harbor.

May 4, 2010

Michigan Supreme Court Justice Robert Young Favors Insurance Company over the Injured Worker

Justice Robert Young is up for re-election in November. Each and every worker in the State of Michigan should remember his decision in the recent Alderman v. J.C. Development Communities case.

On October 9, 2006, Randy Alderman was part of a crew of six men working on a homesite in a new subdivision, adjacent to some power lines. As the crane lowered one of the forms onto the foundation, it contacted a power line. A jolt of electric current flowed through the crane and down the chain to the form and the metal "whaler" plaintiff was using to control the form from the ground. Plaintiff was knocked unconscious and his hands and feet were severely burned, requiring skin grafts.

Justice Young reversed the Court of Appeals decision and threw out Randy's case. Why? Because "The only employees exposed to the risk of electrocution were two to six employees of one subcontractor, including the plaintiff, and therefore there was not a high degree of risk to a significant number of workers." I guess in Justice Young's world since only 6 people were at risk of electrocution and only one guy actually got electrocuted its no big deal. I suspect that Randy Alderman and his family might disagree.

Who benefited from this decision? Defendant J.C. Development LLC and its liability insurance company.

Who was harmed by this decision. The worker- Randy Alderman.
Who is going to pay Randy's medical bills now??? Not the insurance company or corporate defendant that's for sure.

This is just the latest in a long string of decisions that Justice Young has decided giving a free pass to the insurance companies and corporate interests.

April 2, 2010

Discovery in Long Term Disability Insurance claims-the door opens a little wider

For years, long term disability insurance claimant's were prevented from conducting even the most basic discovery. The court's having basically accepted the disability insurer's arguments that they could only examine the records that the disability insurer reviewed in making the claims decision. However, that approach has changed since the Metlife v Glenn decision.

A recent decision issued by the US District Court in Detroit illustrates perfectly the subtle shift now taking place where the Court allowed plaintiff to actually depose the two physicians relied upon by the Standard Insurance Company to deny plaintiff's claim for long term disability benefits.

Plaintiff's counsel discovered that one of the physicians, Dr. Dickerson had been used over and over again to terminate disability benefit claims. A simple search of the case law provided at least a dozen other cases in which Standard used this expert. Counsel for plaintiff astutely asked:

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April 1, 2010

Which Long Term Disability Insurance should you buy?

Just like other forms of insurance , your Long Term Disability Insurance is only as good as the Company providing it and the policy they sell. Every time I see a "Good Hands" commercial or a "like a good neighbor" commercial I think that for every dollar an insurance company spends on advertising it is a dollar that it cannot spend to pay claims.

A recent ranking of insurance companies identified a number of familiar names as the worst including several Long Term Disability Insurers. While my experience is strictly unscientific, I have seen a number of these same insurers consistently denying meritorious claims. I have filed many ERISA claims and lawsuits to reverse these denials.

So, be careful who you get your LTD insurance from. There is probably a reason that one company's policy is less expensive. If meritorious claims are denied, the company can afford to accept a lower premium rate. Here are the top ten (or bottom ten) companies based on claims denied rankings:

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December 17, 2009

SMDA OBTAINS TRUCKING ACCIDENT JUDGMENT AGAINST INSURANCE COMPANY DUE MCS90 ENDORSEMENT

In addition to our work on Long Term Disability cases, Serafini, Michalowski, Derkacz & Associates (SMDA) also handles personal injury cases. This is the story of one such case.

Our client, James Hawthorne was rear ended by a semi-truck owned and operated by a Kentucky based Trucking company. Mr. Hawthorne hired our firm to pursue a claim against the at-fault driver when he was unable to return to work due to a serious neck injury (due to whiplash).

SMDA filed a lawsuit against the trucking company in the Wayne County Circuit Court. Despite being served with the complaint by the local sheriff, the trucking comapny failed to appear in the case and was defaulted. Despite receiving notice of the default, the Trucking company again failed to appear in the case and a default judgment ($942,000) was entered by the Court.

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December 15, 2009

WHY SHOULD LTD INSURERS PAY?

From the Insurance Companies perspective, the answer is simple- there is no reason for them to pay.

My clients are universally surprised to learn that under ERISA the only thing you can sue for are the unpaid LTD benefits. There is no claim for emotional distress, or pain and suffering. There is no claim for bad faith or anything else. The vast majority of Long Term Disability claims are governed by a federal law (ERISA) because they are part of an employer provided benefits package.

I regularly hear tragic tales of financial devastation. Clients are unable to pay their bills, are losing their cars and their homes. Clients are forced to rely on their friends and families and the charity of strangers.

Guess what? The insurance companies could care less. You see, the LTD insurer gets to review your claim and decide if they want to pay or not. If they decide they don't want pay your claim, they simply deny your application and hope you give up. If they approve your claim, then they have to pay and in turn make less money. Every dollar they pay on your claim is a dollar less of profit to line their pockets.

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October 13, 2009

Discovery in Long Term Disability Cases-A breathe of life

Most Long Term Disability cases in our office are governed by ERISA as they are non-governmental employer provided benefits. The fact that they are ERISA claims is usually all bad for our clients as the law in this area has a number of inherent anti-claimant aspects. Primary among those aspects is that discovery was typically extremely limited or, more often simply not allowed.

What is discovery and why is it important?

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October 12, 2009

Court Rejects Long Term Disability Insurer (Unum's) Denial after a Decade

The federal 8th Circuit Court of Appeals rejected a Long Term Disability Insurer's (Unum Life Insurance Company) claim denial in the case of Chronister v Unum Life. Citing an important change in the law since Metlife v Glenn the Court determined that Unum's failure to comply with its own claims handling manual was an important factor leaving the "firm impression that Unum's decision to deny the claim was an abuse of discretion."

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July 22, 2009

Does a parent's life have value for a child? (A Thorn in the side of the Gang of Three)

Recently, the new majority of 4 Michigan Supreme Court Justices upheld a decision by the Court of Appeals in Thorn v Mercy Memorial Hospital. In Thorn, a mother of young children died as a result of a medical error. When the family sued the defendant's argued that the children could not recover any of the economic cost of paying to try and replace the services that their mother would have provided during their lifetime. The Court of Appeals rejected this argument.

The Defendant's appealed this decision to the Michigan Supreme Court. The Supreme Court decided that the Court of Appeals got it right and upheld the decision.Justice Robert Young (who is up for re-election in 2010) strongly disagreed.

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June 25, 2009

Don't Trust the Insurance Industry says the Insurance Industry (Cigna)

In testimony presented to Congress, the Washington Post recently reported on the testimony of Cigna Insurance's former VP, Wendell Potter who said insurers "make paperwork confusing because 'they realize that people will just simply give up and not pursue it' if they think they have been shortchanged."

Referring to the industry's objection to changing its business, Potter said he "worries 'that the industry's charm offensive, which is the most visible part of duplicitous and well-financed PR and lobbying campaigns, may well shape'" insurance reform in a way that is more beneficial to Wall Street than to "average Americans."

This "charm offensive" reminds me of those terrific Allstate commericals where the good looking gentleman says "Your in good hands with Allstate" after some vaguely disturbing scenario is played out in the background. Man, who wouldn't want to be in Allstate's hands. Unfortunately, when it comes time to pay a claim many of my client's feel like Allstate laced up some boxing gloves to cover those "good hands."

ABC news provides details of Mr. Potters testimony here.

June 25, 2009

SMDA Partner-Patrick Derkacz attends ACI Long Term Disability Insurance Conference

In my continuing effort to do the best job that I can for my Long Term Disability Insurance clients I attended that ACI Long Term Disability Insurance Conference in Boston this past week. For the the second year in a row that I have attended this conference I thought it was excellent. The seminar presenters were all top notch-clearly some of the best and brightest practicing in this niche area.

There were a number of very interesting and useful sessions dealing with the Supreme Court's Metlife v Glenn decision and how it is impacting cases across the country as well as various other in depth discussions on a number of relevant issues. The last day we had a panel of a half-dozen federal court judges discuss their view's of these cases.