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As a reader of this blog site, you are likely aware of the class action lawsuit filed by the Law Office of Shawn E. McDermott against Standard Insurance Company and the Colorado Public Employee Retirement Association (PERA). This case is pending in Denver District Court. The basis of the lawsuit is our firm conviction that the PERA Rule 7.45(E) and the PERA short term disability policy issued by Standard Insurance for the benefit of all PERA members does not comply with the law. See my previous blog posts for a more detailed description of this lawsuit by clicking here.
As counsel for Plaintiff in the class action lawsuit filed by our client, Tracey Lawless, we have filed a motion to certify the case as a class action under Rule 23. The issue is now fully briefed and awaiting the court’s decision. Perhaps more importantly, we have also filed our dispositive motion and extensive legal brief asking Judge Hood to agree with our position that the “second prong” of the short term disability (STD) definition found in the policy must beremoved as it is not supported by and is entirely inconsistent with the PERA statute defining when a PERA member is entitled to STD payments. As of earlier this week, the dispositive motions filed by all parties are also now fully briefed. We simply await the Judge’s determination.
As a reminder to all who may be affected, if you believe your case fits within this proposed class or if you have any other questions regarding your Colorado PERA disability retirement claim or denial, you can always contact the disability insurance lawyers at our office for an initial, free consultation.
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We recently learned that Standard Insurance Company has agreed with the position we took on behalf of a client whose claim for long term disability benefits had been denied. Our client’s claim was somewhat unique in that she had been receiving long term disability benefits for several years due to her chronic cardiac condition and related medical issues including a diagnosis of bi-polar disorder. Hoping that she had regained some stamina and because she was frustrated with living too simplified of a life, basically staying at home, our client wanted to attempt a return to employment. Wisely, before doing so, she spoke with the claims representative at Standard Insurance who ensured her that she had a 180-day window within which to attempt to return to work and that if she was unable to do so, her disability benefits would recommence, a.k.a a recurrent disability claim. Relying on this representation our client returned to work for a couple of months and quickly realized her medical condition did not allow her to do so. In contacting her claims representative after the return-to-work failed, she was shocked to learn that the reinstatement of disability benefits would not occur, because she had not returned to her former employer for the trial return to work period. (more…)
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Our disability clients are often surprised to hear that their life insurance coverage may continue in full force and effect even if they are disabled and cant work. Most individuals have coverage in the event of disability or death through benefits or policies of insurance provided by their employer. If so, such claims are likely governed by ERISA (Employee Retirement Income Security Act). Most group life insurance policies contain what is often called a “waiver of premium” provision which provides that the life insurance protection continues without having to pay a premium (more…)
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On Monday, March 7, 2011, our office filed a class action lawsuit against The Standard Insurance Company and Colorado Public Employees Retirement Act (PERA). The basis of this class action lawsuit is discussed in several prior blogs on this website. You may want to review our prior blog from August 26, 2010 as well as our blog on January 19, 2011. Click here for a link to our website further describing PERA disability benefits.
The amended complaint in Lawless v. Standard and PERA, pending in the Denver District Court, seeks certification of a class whose members are defined as those PERA members whose claim for short term disability benefits have been denied (more…)
The Texas Department of Insurance has adopted a new rule prohibiting discretionary clauses in disability insurance policies. Texas now joins the growing list of a number of states which have undertaken similar action. The ban applies to group life and disability policies and is similar to Colorado’s ban on discretionary clauses as found in C.R.S. § 10-3-1116. For a brief description of Colorado’s ban on discretionary clauses, see our prior blog post by clicking here. (more…)
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The disability insurance attorneys at the Law Office of Shawn E. McDermott prevailed in a recent ERISA appeal filed on behalf of their client when Life Insurance Company of North America (LINA), a subsidiary of CIGNA, wrongfully terminated his long term disability benefits.
In the claim against LINA, Mr B was originally rendered disabled by bladder cancer which had gone into remission. However, at the time of the termination of long term disability benefits, he began suffering from (more…)
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The disability insurance lawyers at the Law Office of Shawn E. McDermott prevailed in a recent ERISA appeal filed on behalf of their client when Hartford Life & Accident Insurance Company wrongfully terminated her long term disability benefits.
In the claim against Hartford Life & Accident Insurance Company Ms. H suffered from the following conditions: (more…)
We have received an alarming increase in the number of phone calls from PERA Members whose disability claims have been denied by Standard Insurance Company. This office first started noticing this up-tick in incoming calls in the fall of 2010. The fact that Standard Insurance will be replaced by Unum Insurance as the PERA Disability Program Administrator from 2011 moving forward may have something to do with this increase in the number of denied claims experienced by this office.
We have recently filed four new law suits against Standard Insurance and PERA and anticipate filing at least a few more over the next month or so. The vast majority of these claims were denied under the so called “second prong” of the definition of short term disability (more…)
A Federal Court Magistrate Judge recently ordered Qwest Disability Plan to pay Plaintiff’s attorney’s fees in an action pending in the United States District Court for the District of Colorado.
In Robin Cross v. Qwest Disability Plan, Magistrate Judge Kathleen M. Tafoya awarded attorney’s fees in favor of Plaintiff Cross whose disability benefits had been reinstated during the course of litigation. The Court ordered Defendant to pay for all but a small portion of Plaintiff Cross’s attorney time incurred on the claim. The Court determined that (more…)
As attorneys representing claimants whose disability, health or life benefits have been denied, we have grown accustomed to waging a battle over the ability to engage in discovery of information outside of the so called administrative record in cases governed by the Employee Retirement Income Security Act (“ERISA”). Generally, the law in the 10th Circuit as well as most other Circuits in this country limit a judge’s review of a denied long term disability claim to the ERISA record, a.k.a the insurance company’s claim file. We have often argued that an ERISA claimant is entitled to learn more of the insurance company’s claims handling procedures, the adequacy of those procedures and whether they were adhered to, and information concerning the potential bias of the physician reviewers hired by such insurers to review a claimant’s medical condition and ability to work.
In Murphy v. Deloitte & Touche Group Ins. Plan, 619 F.3d 1151 (10th Cir. 2010), the Tenth Circuit Court of Appeals addressed the scope of discovery permitted when there is a conflict of interest. (more…)
