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	<title>www.colorado-disability-lawyer.com</title>
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		<title>PERA Short Term Disability Claims &#8211; Improper Claims Handling &#8211; Standard Insurance</title>
		<link>http://www.colorado-disability-lawyer.com/blog/pera-claims/pera-short-term-disability-claims-improper-claims-handling-standard-insurance/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/pera-claims/pera-short-term-disability-claims-improper-claims-handling-standard-insurance/#comments</comments>
		<pubDate>Thu, 26 Aug 2010 21:26:15 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Disability]]></category>
		<category><![CDATA[PERA Claims]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=531</guid>
		<description><![CDATA[Our office has uncovered what we believe to be a significant error in the way the Colorado Public Employee Retirement Association (PERA) administers its disability retirement program.  As a Colorado PERA member, you may be entitled to certain disability benefits if you are no longer able to work.  The PERA Disability Retirement Program [...]]]></description>
			<content:encoded><![CDATA[<p>Our office has uncovered what we believe to be a significant error in the way the Colorado Public Employee Retirement Association (<a href="http://www.colorado-disability-lawyer.com/html/pera.html">PERA</a>) administers its disability retirement program.  As a Colorado PERA member, you may be entitled to certain disability benefits if you are no longer able to work.  The PERA Disability Retirement Program consists of two parts: (1) Short term disability (STD) benefits which are paid pursuant to a policy issued by Standard Insurance Company, and (2) Disability Retirement Benefits if you are permanently disabled.  PERA STD benefits are payable for a maximum of 22 months.  PERA disability retirement benefits can be payable for your lifetime.  Standard Insurance is the designated program administrative which makes all disability determinations, whether STD or disability retirement. </p>
<p>In our opinion, and the opinion of at least one Colorado District Court Judge, the PERA STD benefits are being administered by Standard Insurance in a way that is not consistent with the applicable statutory definition.  We have come across many denied claims on behalf of potential and current clients which are in fact payable, yet were denied by Standard.   </p>
<p>If you have been denied PERA STD benefits by Standard Insurance, you are encouraged to contact our law office.  Our lawyers and legal staff will help you determine if your claim was properly handled by Standard, whether the correct disability determination was reached, and your potential avenues of recourse if not.  We can assist with your appeal of the disability denial directly with the insurance company or file and pursue a lawsuit if necessary.  </p>
<p>For additional information on the PERA Disability Retirement Program, visit teh PERA section of our legal website.  Click <a href="http://www.colorado-disability-lawyer.com/html/pera.html">here</a>.  </p>
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		<title>PERSONAL INJURY CLAIMS AGAINST RTD ARE LIMITED</title>
		<link>http://www.colorado-disability-lawyer.com/blog/1/personal-injury-claims-against-rtd-are-limited/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/1/personal-injury-claims-against-rtd-are-limited/#comments</comments>
		<pubDate>Thu, 08 Apr 2010 19:32:42 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[1]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=501</guid>
		<description><![CDATA[	A horrific accident occurred in Denver on Saturday, April 3, 2010 in which two people riding in another vehicle were tragically killed when struck by an RTD bus.  From a legal standpoint, the relatives of the deceased will never receive fair compensation for their losses, regardless of the conduct of the bus driver.  [...]]]></description>
			<content:encoded><![CDATA[<p>	A horrific accident occurred in Denver on Saturday, April 3, 2010 in which two people riding in another vehicle were tragically killed when struck by an RTD bus.  From a legal standpoint, the relatives of the deceased will never receive fair compensation for their losses, regardless of the conduct of the bus driver.  According to witnesses, the RTD bus ran a red light and struck two vehicles.  The RTD bus was being driven by an employee for a private contractor, Veolia Transportation.  According to the Colorado Court of Appeals in the decision of Henisse v. First Transit Inc., the contractors of RTD service are considered employees of RTD and therefore covered (and protected) by the Colorado Governmental Immunity Act.  As an special district or  instrumentality of the State of Colorado, RTD is considered a governmental entity.  Regardless of the conduct involved, a governmental entity in the State of Colorado cannot be held responsible for damages to injured individuals for more than a maximum of $150,000 per person, or a total of $600,000 per accident.  The value of the losses suffered by the surviving relatives of these two individuals clearly exceed the $150,000 limitation, but their chance of recovery of amounts greater than that appear slim at this point in time.  </p>
<p>	In this attorney’s opinion, private contractors to a governmental entity should not be considered public employees for the purposes of protection under the Governmental Immunity Act.  Veolia Transportation is a private company and employed private employees.  The drivers of RTD buses, which have the ability to cause far more damage than your average motor vehicle, should face the same exposure as every other driver on the road &#8211; such as you and me &#8211; who do not enjoy such protections.  The Court of Appeals opinion in Henisse v. First Transit Inc. impermissibly expands the Colorado Governmental Immunity Act beyond its intended scope.  The case has been appealed to the Supreme Court of the State of Colorado and will hopefully be overturned.  We have addressed these issues in representing past clients in <a href="http://www.colorado-disability-lawyer.com/html/auto-accident.html">automobile accident injury </a>cases.  Similarly, we have faced the same argument from Standard Insurance who claims that it is an agent of Colorado PERA for purposes of administrating its disability retirement program.  That issue has been successfully resolved in front of the Court of Appeals.  Standard Insurance no longer makes that claim to immunity in the <a href="http://www.colorado-disability-lawyer.com/html/pera.html">PERA disability benefit cases </a>we litigate for clients.  </p>
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		<title>ANOTHER FAVORABLE ERISA DECISION ALLOWING DISCOVERY</title>
		<link>http://www.colorado-disability-lawyer.com/blog/erisa-claims/another-favorable-erisa-decision-allowing-discovery/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/erisa-claims/another-favorable-erisa-decision-allowing-discovery/#comments</comments>
		<pubDate>Mon, 15 Mar 2010 19:23:36 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Disability]]></category>
		<category><![CDATA[ERISA Claims]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=431</guid>
		<description><![CDATA[	Magistrate Judge Kristen Mix of the U.S. District Court for the District of Colorado recently found in favor of an ERISA long-term disability claimant’s right to conduct discovery.  This order can be found in Almedia v. Hartford Life and Accident Insurance Company, No. 09-cv-01556-ZLW-KLM, 2010 WL 743520 (D.Colo. March 2, 2010).  In reaching [...]]]></description>
			<content:encoded><![CDATA[<p>	Magistrate Judge Kristen Mix of the U.S. District Court for the District of Colorado recently found in favor of an ERISA long-term disability claimant’s right to conduct discovery.  This order can be found in <em>Almedia v. Hartford Life and Accident Insurance Company</em>, No. 09-cv-01556-ZLW-KLM, 2010 WL 743520 (D.Colo. March 2, 2010).  In reaching the conclusion that discovery is permitted in ERISA governed LTD case, Judge Mix cited to and partially relied upon a decision in prior case handled by this office, <em>Kohut v. Hartford Life and Accident Insurance Company</em>.  </p>
<p>	Similar to the issues this office had pursued in the past, the Plaintiff in Almedia sought discovery concerning the scope of the conflict between Hartford Insurance and the third party independent medical reviewers and professionals it utilizes to deny claims.  Plaintiff also sought information concerning potential improper incentives paid to Hartford employees who rendered claim decisions, information concerning Hartford’s claims manuals, training and claims guidelines and <span id="more-431"></span>statistical data relating to claims administration.  </p>
<p>	We applaud Judge Mix for recognizing the importance of discovery in ERISA governed claims and allowing Plaintiff Almedia to pursue evidence outside of the insurance company’s claim file.  This office is hopeful the 10th Circuit Court of Appeals will eventually address this issue once and for all, and decide that discovery is most definitely allowed in all ERISA governed claims.  Such a decision will speed up the litigation process by several months which is now spent fighting over the right to conduct discovery.</p>
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		<title>FAVORABLE RULINGS RECEIVED IN PERA DISABILITY CLAIM</title>
		<link>http://www.colorado-disability-lawyer.com/blog/pera-claims/favorable-rulings-received-in-pera-disability-claim/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/pera-claims/favorable-rulings-received-in-pera-disability-claim/#comments</comments>
		<pubDate>Wed, 03 Feb 2010 17:18:49 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Disability]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[PERA Claims]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=381</guid>
		<description><![CDATA[
This office handles a great many number of claims on behalf of PERA Members who are seeking disability benefits.  The PERA Disability Program is administered by Standard Insurance Company.  For a more detailed discussion of PERA issues, please refer to the PERA disability section of our website by clicking here.
This office recently concluded [...]]]></description>
			<content:encoded><![CDATA[<p>
This office handles a great many number of claims on behalf of PERA Members who are seeking disability benefits.  The PERA Disability Program is administered by Standard Insurance Company.  For a more detailed discussion of PERA issues, please refer to the PERA disability section of our website by clicking <a href="http://www.colorado-disability-lawyer.com/html/pera.html">here</a>.</p>
<p>This office recently concluded litigation in the case of Leticia Nunez v. Standard Insurance and PERA.  Several important rulings on legal issues were obtained from Judge Frank Plaut who was sitting by designation as the district court judge in Kit Carson County.  On behalf of Ms. Nunez, we took the position that the short term disability (STD) policy issued by Standard Insurance Company to PERA for <span id="more-381"></span>the purpose of covering all PERA members contained a definition of disability that did not comply with the definition of short term disability benefits established by state law.  More specifically, we argued that the “second prong” of the definition which requires a PERA member to prove not only an inability to perform the essential functions of their own job, but to also show an inability to earn 75% of predisability earnings in some other occupation, should not exist in the policy.  The second prong of the definition tracks the language found in PERA Rule 7.45(e).  We argued that PERA inappropriately adopted that rule as it was inconsistent with the statutory definition.  Judge Plaut agreed. </p>
<p>Additionally, the Court ruled that Standard’s handling of the voluntary, third level of review was done incorrectly.  The PERA statutes and rules guarantee that a PERA member whose disability benefit claim has been denied is entitled to a final medical determination to be conducted by a “panel of independent experts.”  In Ms. Nunez’s case, the final level of review was performed by one physician. Judge Plaut ruled, as a matter of law, that a review by one physician does not constitute a review by a panel of independent experts.  Based upon Judge Plaut’s ruling, Standard Insurance informed our office that it intended to re-conduct the third level of review in two other cases we are currently litigating.  </p>
<p>The Law Office of Shawn E. McDermott, LLC is actively pursuing these same and other issues on behalf of other PERA members.  We represent these individuals following a denial of benefits by Standard Insurance Company.  We have experience representing individuals through the internal appeal process with Standard Insurance and in litigation against Standard and PERA, if necessary.</p>
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		<title>ERISA&#8217;s Exemption for Governmental Plans and Right to Jury Trial &#8211; According to the Tenth</title>
		<link>http://www.colorado-disability-lawyer.com/blog/erisa-claims/erisas-exemption-for-governmental-plans-and-right-to-jury-trial-according-to-the-tenth/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/erisa-claims/erisas-exemption-for-governmental-plans-and-right-to-jury-trial-according-to-the-tenth/#comments</comments>
		<pubDate>Wed, 03 Feb 2010 16:56:19 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Disability]]></category>
		<category><![CDATA[ERISA Claims]]></category>
		<category><![CDATA[Insurance]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=331</guid>
		<description><![CDATA[The 10th Circuit Court of Appeals recently issued a decision addressing two ERISA issues: (1) what constitutes a “governmental plan;” and (2) the right to trial by jury.  These issues were addressed in the case of Shirley Graham v. Hartford Life and Accident Insurance Company, 589 F.3d 1345 (10th Cir. 2009), decided December 29, [...]]]></description>
			<content:encoded><![CDATA[<p>The 10th Circuit Court of Appeals recently issued a decision addressing two ERISA issues: (1) what constitutes a “governmental plan;” and (2) the right to trial by jury.  These issues were addressed in the case of Shirley Graham v. Hartford Life and Accident Insurance Company, 589 F.3d 1345 (10th Cir. 2009), decided December 29, 2009.  This was an appeal out of the Northern District of Oklahoma.  </p>
<p>At issue was Ms. Graham’s claim for long-term disability (LTD) income protection benefits.  She was a former employee of the United States Postal Service (USPS).  Unlike most LTD plans, Ms. Graham was insured under a plan established by the National Rural Letter Carriers Association (NRLCA), recognized by the USPS as the exclusive bargaining representative for rural letter carriers.  The NRLCA procured the group long term disability policy from Hartford.  USPS was not involved in those negotiations, nor did it sponsor the plan.  Given these facts, the Court concluded that although Ms. Graham was considered a governmental employee of the USPS, the actual plan and policy at issue was obtained by an employee organization, and not the governmental employer.  As a result, the plan was not a “governmental plan” and therefore not exempted from ERISA.  <span id="more-331"></span></p>
<p>Similar to Ms. Graham’s case, my office undertakes an analysis of every new client as to whether ERISA governs the dispute with the plan or the insurance company.  The irony is that a plan participant (employee) typically does not want to have their case governed by ERISA if at all possible, even though ERISA was allegedly passed to protect just that individual.</p>
<p>The second legal issue addressed by the Graham decision was whether there exists a right to a jury trial in a claim for benefits under 29 U.S.C. § 1132(a)(1)(B).  Following a prior decision in the 10th Circuit, and consistent with many other circuits which have addressed this issue, the Court found that no Seventh Amendment right to jury trial attaches to such a claim.  </p>
<p>As a side note, a law enacted in the State of Colorado in August 2008 found at C.R.S. §10-3-1116 specifically states that all claims under an insurance policy are to have that controversy decided by a jury trial, if requested by the Plaintiff.  The question remains unanswered whether this recently enacted Colorado law would be preempted by ERISA.   </p>
<p>The Law Office of Shawn E. McDermott, LLC has addressed issues similar to those presented in the Graham case.  We have represented, and continue to represent, multiple individuals whose disability benefits have been denied including those who were in fact considered to be a governmental plan and thus not subject to ERISA.  Please feel free to contact our office if you have any questions concerning the denial of your claim for long term disability benefits under either an individual policy you have purchased on your own or one that you find your self a participant of by virtue of your employment.  </p>
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		<title>Favorable Ruling against Pre-emption of Colorado&#8217;s Ban on Discretionary Clauses in ERISA Disability Case</title>
		<link>http://www.colorado-disability-lawyer.com/blog/erisa-claims/favorable-ruling-against-pre-emption-of-colorados-ban-on-discretionary-clauses-in-erisa-disability-case/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/erisa-claims/favorable-ruling-against-pre-emption-of-colorados-ban-on-discretionary-clauses-in-erisa-disability-case/#comments</comments>
		<pubDate>Tue, 11 Aug 2009 20:52:16 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Disability]]></category>
		<category><![CDATA[ERISA Claims]]></category>
		<category><![CDATA[Insurance]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=291</guid>
		<description><![CDATA[	Earlier this year, the Law Office of Shawn E. McDermott, LLC received a favorable decision from the United States District Court Judge Christine M. Arguello in an ERISA long term disability case involving two important issues.  The case handled by this office is titled Mark Kohut v. Hartford Life and Accident Insurance Company and [...]]]></description>
			<content:encoded><![CDATA[<p>	Earlier this year, the Law Office of Shawn E. McDermott, LLC received a favorable decision from the United States District Court Judge Christine M. Arguello in an ERISA long term disability case involving two important issues.  The case handled by this office is titled <em>Mark Kohut v. Hartford Life and Accident Insurance Company </em>and has now been published by WestLaw at __ F.Supp.2d __, 2008 WL 5246163 (D. Colo.).   This disability case was subsequently resolved by agreement of the plaintiff and disability insurance company, Hartford Insurance. </p>
<p>	As mentioned in an earlier blog, dated June 5, 2008, the Colorado legislature adopted C.R.S. §10-3-1116 which bans the use of “discretionary clauses” within any insurance policy, including group policies, issued in Colorado.  We believe this is the first decision issued <span id="more-291"></span>by a Colorado federal court judge finding that Colorado’s new statute is not pre-empted by ERISA, meaning that it applies to all insurance benefit disputes.  Removal of the discretionary clauses from ERISA-governed policies in Colorado results in the court being able to decide on its own whether the insurance company’s decision was right or wrong (know as a de novo standard of review), with no deference being given to the insurance company’s internal decision.  This should result in far more equitable and realistic reviews of such denials in the future by Colorado judges.  On an unfortunate note, the court ruled that the statute could not be applied retroactively to the case as the insurance denial occurred prior to the enactment of the new statute.  Not so good news for Mr. Kohut’s case but a very favorable result for future ERISA disability claims handled by this office in the state of Colorado.</p>
<p>	On the second issue, Judge Arguello ruled that discovery could be conducted by Mr. Kohut’s attorneys and the court would look beyond the insurance company’s claim file to determine the seriousness of Hartford Life and Accident Insurance Company’s conflict of interest in rendering determinations (i.e. denying long term disability claims).  This office has received many favorable orders on the issue of discovery, including the reported cases of <em>Hoyt v. Prudential Ins. Co. of Am</em>., No. 07-cv-02210-LTB-KLM, 2008 WL 686922 (D.Colo. Mar. 12, 2008) and <em>Jeffryes v. Hartford Life &#038; Accident Ins. Co</em>., No. 05-cv-01770-EWN-CBS, 2006 WL 1186493 (D.Colo. May 4, 2006). </p>
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		<title>THE AMERICAN RECOVERY AND REINVESTMENT ACT- IMPACT ON COBRA RIGHTS</title>
		<link>http://www.colorado-disability-lawyer.com/blog/uncategorized/the-american-recovery-and-reinvestment-act-impact-on-cobra-rights/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/uncategorized/the-american-recovery-and-reinvestment-act-impact-on-cobra-rights/#comments</comments>
		<pubDate>Fri, 24 Apr 2009 20:42:50 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=251</guid>
		<description><![CDATA[&#8230;&#8230;
	The President recently signed into law an economic stimulus package titled The American Recovery and Reinvestment Act.  This law may impact your health care and other employee benefits.  The plan includes provisions to assist certain eligible jobless workers  pay for health insurance under COBRA.  COBRA applies to employers with 20 or [...]]]></description>
			<content:encoded><![CDATA[<p>&#8230;&#8230;<br />
	The President recently signed into law an economic stimulus package titled The American Recovery and Reinvestment Act.  This law may impact your health care and other employee benefits.  The plan includes provisions to assist certain eligible jobless workers  pay for health insurance under COBRA.  COBRA applies to employers with 20 or more employees and, specifically allows newly unemployed workers to keep health insurance provided by their former employers.  The new American Recovery and Reinvestment Act makes COBRA coverage more accessible to former employees. </p>
<p>	For workers who are involuntarily terminated for reasons other than gross misconduct between September 1, 2008 and December 31, 2009, the federal government will subsidize 65% of the premiums under COBRA for nine months.  Additionally, for involuntarily employees who did not sign up for COBRA originally have been granted an additional 60 days within which to do so.</p>
<p>	There is a high income exclusion however.  If your adjusted gross income exceeds $125,000 per year or $250,000 per family, the income tax will be raised by the premium reduction amount which effectively removes the subsidy.  </p>
<p>	If you have lost your job involuntarily in this economic downturn, it is possible your rights under COBRA have been impacted.  You may want to contact your employer to determine if you have the right to enroll in COBRA healthcare coverage or have the right to seek a subsidy under this new Act.   </p>
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		<title>LILLY LEDBETTER AND OBAMA’S FIRST BILL SIGNED INTO LAW</title>
		<link>http://www.colorado-disability-lawyer.com/blog/uncategorized/lilly-ledbetter-and-obama%e2%80%99s-first-bill-signed-into-law/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/uncategorized/lilly-ledbetter-and-obama%e2%80%99s-first-bill-signed-into-law/#comments</comments>
		<pubDate>Thu, 29 Jan 2009 21:21:24 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=231</guid>
		<description><![CDATA[	The U.S. Congress and our newly inaugurated President Obama signed into law this morning the Lilly Ledbetter Fair Pay Act.  This new law is a clear repudiation of the conservative Supreme Court’s ruling last year in Ledbetter v. Goodyear which many legal scholars agree wiped out years of employment law precedence on equal pay [...]]]></description>
			<content:encoded><![CDATA[<p>	The U.S. Congress and our newly inaugurated President Obama signed into law this morning the Lilly Ledbetter Fair Pay Act.  This new law is a clear repudiation of the conservative Supreme Court’s ruling last year in Ledbetter v. Goodyear which many legal scholars agree wiped out years of employment law precedence on equal pay provisions.  While my law office emphasizes representing clients with employee benefit claims, as compared to the equal pay, wrongful termination and discrimination suits seen in the broader practice of employee rights, this new law is still worthy of mention. </p>
<p>	Ms. Ledbetter is a former employee of Goodyear Tire and Rubber Company in a plant located in Gadsden, Alabama.  She worked there for more than 19 years <span id="more-231"></span>and had suspected her male counterparts performing the exact same job on different shifts were paid more than herself.  At one point, someone slipped into her company mailbox a copy of her pay stub and a copy of a male counterpart’s pay stub.  With this proof in hand, she went to the EEOC and filed a complaint.  The evidence was that all of her male counterparts made more money than she did.  Even the most junior of those counterparts, who had worked at the company for far less time than Ms.  Ledbetter earned, approximately $6,000 per year more than she did.  Eventually the case proceeded to an outraged  jury which awarded significant damages and attorney’s fees under the pay discrimination provisions of Title VII of the Civil Rights Act of 1964 and the Equal Pay Act of 1963.  </p>
<p>	Last year her case eventually found its way to the United States Supreme Court where Justice Alito authored the opinion which held that any “discriminatory intent” of Goodyear did not occur within 180 days prior to Ms. Ledbetter filing the complaint with the EEOC.  The court found unpersuasive Ledbetter’s claim that each check served as an act of discrimination and the clock did not run on past injustices.  Justices Ginsberg, Stevens, Souter, and Breyer dissented in this five to four decision of the Court.  The final result was that the Supreme Court gutted her case and she recovered nothing despite the clear evidence of discrimination over a very long period of time.  The majority opinion of the Supreme Court literally suggests that Ms. Ledbetter was required to have filed her complaint within six months of the original act of discrimination despite the clear evidence that she did not know that she was being discriminated against.  </p>
<p>	Congress essentially overturns the Supreme Court’s decision with this new law signed today, although its prospective application will not help the injustice experienced by Ms. Ledbetter.  Even more outrageous is to hear the opponents contend that today’s legislation is nothing more than a “boon to trial lawyers.  This bill has nothing to do with protecting trial lawyers or encouraging lawsuits but was enacted to protect those like Lilly Ledbetter who were clearly discriminated against and whose legal protections were ignored by our highest court.  </p>
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		<title>Insurance Companies&#8217; Tricks of the Trade</title>
		<link>http://www.colorado-disability-lawyer.com/blog/insurance/insurance-companies-tricks-of-the-trade/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/insurance/insurance-companies-tricks-of-the-trade/#comments</comments>
		<pubDate>Thu, 13 Nov 2008 23:25:20 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Insurance]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=221</guid>
		<description><![CDATA[	The American Association for Justice (formerly the Association of Trial Lawyers of America) recently released a new report on the insurance industry titled “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse.”  The report reviews some of the egregious ways the industry attempts to make large sums of money at the [...]]]></description>
			<content:encoded><![CDATA[<p>	The American Association for Justice (formerly the Association of Trial Lawyers of America) recently released a new report on the insurance industry titled “Tricks of the Trade: How Insurance Companies Deny, Delay, Confuse and Refuse.”  The report reviews some of the egregious ways the industry attempts to make large sums of money at the expense of their insureds, the consumer.  The report details six methods that directly impact policy holders.  It identifies the insurers who are engaging in these practices.  Finally, it reviews what each consumer can do to resist these tactics.   Review the AAJ report by clicking <a href=" http://www.justice.org/InsuranceTactics.pdf">here</a>.  </p>
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		<title>Successful Underinsured Motorist Claim &#8211; Appellate Decision</title>
		<link>http://www.colorado-disability-lawyer.com/blog/auto-accidents/successful-underinsured-motorist-claim-appellate-decision/</link>
		<comments>http://www.colorado-disability-lawyer.com/blog/auto-accidents/successful-underinsured-motorist-claim-appellate-decision/#comments</comments>
		<pubDate>Thu, 30 Oct 2008 18:45:19 +0000</pubDate>
		<dc:creator>Shawn McDermott</dc:creator>
				<category><![CDATA[Auto Accidents]]></category>
		<category><![CDATA[Auto Insurance]]></category>
		<category><![CDATA[Insurance]]></category>
		<category><![CDATA[Uninsured/Underinsured Motorist Claims]]></category>
		<category><![CDATA[Wrongful Death]]></category>

		<guid isPermaLink="false">http://www.colorado-disability-lawyer.com/blog/?p=211</guid>
		<description><![CDATA[	The Law Office of Shawn E. McDermott LLC recently won a Colorado appellate case on behalf of its clients relating to uninsured/underinsured (UM/UIM) automobile insurance benefits.  In this case, our clients, the Meza family members, had pursued a wrongful death claim under six different underinsured motorist policies issued to various family members of the [...]]]></description>
			<content:encoded><![CDATA[<p>	The Law Office of Shawn E. McDermott LLC recently won a Colorado appellate case on behalf of its clients relating to <a href="http://www.colorado-disability-lawyer.com/html/auto-accident.html#uninsured">uninsured/underinsured (UM/UIM)</a> automobile insurance benefits.  In this case, our clients, the Meza family members, had pursued a <a href="http://www.colorado-disability-lawyer.com/html/wrongful-death.html">wrongful death</a> claim under six different underinsured motorist policies issued to various family members of the Meza family.  The claims were based on the tragic death of the family matriarch, Lucia Meza, who died in an automobile accident in 2000.  </p>
<p>This insurance coverage denial case was initiated in 2002 by State Farm Insurance against the Mezas and three other insurance companies including Farmers, American Family and American Standard.  Each of these carriers had denied the UIM claims of the Meza family members for a variety of reasons.  The claims against State Farm and Farmers were resolved a few years ago.  The final piece of the puzzle against American Family and American Standard was placed by the Colorado Court of Appeals with its decision on July 3, 2008 which affirmed the decision of the trial court from two years earlier.  These two companies had improperly and in violation of public policy defined the term “relative” in its insurance policies in such a way to violate Colorado law.  After six years of litigation, the Court of Appeals finally agreed with the legal arguments put forth by the Mezas and our office. </p>
<p>	As the case was not published pursuant to Rule 35(f) of the Colorado appellate rules, it is reproduced below for interested readers:  <span id="more-211"></span></p>
<p>COLORADO COURT OF APPEALS<br />
______________________________________________________________________________<br />
Court of Appeals No.: 06CA2667<br />
Weld County District Court No. 03CV573<br />
Honorable Daniel S. Maus, Judge<br />
______________________________________________________________________________<br />
State Farm Mutual Automobile Insurance Company,<br />
Plaintiff,<br />
v.<br />
American Family Mutual Insurance Company and American Standard Insurance Company of Wisconsin,<br />
Defendants-Appellants,<br />
and<br />
Eliberto Meza, Amelia Meza, Sofi Meza, Irene Meza, Rosalinda Chaparro, Flora Quintana, and Angelita Cordera,<br />
Defendants-Appellees.<br />
______________________________________________________________________________</p>
<p>ORDER AFFIRMED<br />
Division V<br />
Opinion by: JUDGE LICHTENSTEIN<br />
Vogt and Graham, JJ., concur<br />
NOT PUBLISHED PURSUANT TO C.A.R. 35(f)<br />
Announced: July 3, 2008</p>
<p>Harris, Karstaedt, Jamison &#038; Powers, P.C., A. Peter Gregory, Englewood, Colorado, for Defendants-Appellants</p>
<p>The Law Office of Shawn E. McDermott, L.L.C., Shawn E. McDermott, Denver, Colorado, for Defendants-Appellees</p>
<p>	Defendant insurance companies, American Family Mutual Insurance Company (American Family Mutual) and American Standard Insurance Company of Wisconsin (American Standard) (collectively the American Family defendants), appeal the order granting the cross-motion for summary judgment in favor of defendant insureds, Eliberto Meza, Amelia Meza, Sofi Meza, Irene Meza, Rosalinda Chaparro, Flora Quintana, and Angelita Cordero(the Meza defendants). We affirm.</p>
<p>	The essential facts of the case are not in dispute. On December 7, 2000, Lucia Meza was killed in an automobile accident in which the vehicle she was driving was struck by a vehicle driven by Bernice Swisher. Lucia was insured by plaintiff, State Farm Insurance Company.</p>
<p>The underlying action initially was brought as a complaint for declaratory relief by plaintiff to determine whether the policies at issue in the case could be stacked to determine whether Ms. Swisher’s vehicle was underinsured for purposes of coverage under plaintiff’s policy. After the trial court issued a ruling in favor of the Meza defendants, plaintiff appealed to this court. Upon a stipulation, that appeal was dismissed without prejudice.</p>
<p>	Subsequent to the trial court’s determination of plaintiff’s stacking issue, the current issue developed relating to whether Lucia was an‚“insured person” under the insurance policies of Lucia’s daughters, Sofi and Rosalinda. At the time of the accident Sofi and Rosalinda were living at home.</p>
<p>Sofi was a named insured of American Standard and Rosalinda was a named insured of American Standard and of American Family Mutual. Each of these policies provided liability coverage and underinsured motorist (UIM) coverage for an “insured person.” “Insured person” was defined to include a relative living in the same household as the named insured, but only so long as this person, or his or her spouse, did not own a motor vehicle. The American Family defendants denied Sofi’s and Rosalinda’s claims for UIM benefits for the death of their mother, because Lucia owned a motor vehicle.</p>
<p>The Meza defendants and the American Family defendants filed cross-motions for summary judgment and for determination of questions of law. The summary judgment issue before the trial court was limited to whether Lucia was an “insured” as defined under the policies.<br />
	The American Family defendants sought an order determining, as a matter of law, that (1) Lucia did not constitute an insured “relative” under their policies because she owned a motor vehicle; (2) the definition of “relative” in the policies was valid under Colorado law; and (3) the policies thus did not provide UIM benefits for Lucia’s death. The Meza defendants sought an order determining, as a matter of law, that the definition of the term “relative” in the policies violated public policy and that the policies must provide UIM coverage for Lucia’s death.</p>
<p>Finding that the definition of the term “relative” and “its related exclusion in the insurance policies of the American Family Defendants [was] void as against public policy,” the trial court granted the Meza defendants’ cross-motion for summary judgment and denied the American Family defendants’ motions. The court reasoned that (1) the legislative declaration and definitional language of the uninsured/underinsured motorist (UM/UIM) statute, sections 10-4-60 1 and -609, as amended in 2003, require coverage of “insureds” and “resident relatives” without regard to their ownership or non-ownership of a motor vehicle; (2) the definition of the term “relative” in the American Family defendants’ policies was more restrictive than that contained in the 2003 statute; (3) a provision that dilutes, conditions, or limits statutorily mandated coverage violates public policy pursuant to DeHerrera v. Sentry Ins. Co., 30 P.3d 167 (Colo. 2001); and (4) the exclusion contained in the definition of “relative” was a vehicle restriction, andvehicle restrictions are against public policy pursuant to DeHerrera.<br />
The trial court certified its order as final pursuant to C.R.C.P. 54(b). The American Family defendants appeal.</p>
<p>The American Family defendants contend that the trial court erred in granting the Meza defendants’cross-motion for summary judgment because, contrary to the findings of the trial court, the definition of the term “relative” used in their insurance policies does not violate Colorado public policy. We disagree.</p>
<p>I.</p>
<p>We first note that this action arises under a former version of the UM/UIM statute, Ch. 92, sec. 1, § 10-4-609(1), 1983 Colo. Sess.Laws 454 (requiring insurers to offer UM/UIM coverage), and the former Colorado Auto Accident Reparations Act (No-Fault Act), Ch. 94, § 13-25-1, et seq., 1973 Colo. Sess. Laws 334 (formerly codified as amended at § 10-4-701, et seq.; repealed effective July 1, 2003, Ch. 189, sec. 1, § 10-4-726, 2002 Colo. Sess. Laws 649). Thus, we agree with the American Family defendants’ contention that the trial court improperly relied on statutory definitions in the 2003 amendments to the UM/UIM statute that were not in effect at the time of the accident. See Pollock v. Highlands Ranch Cmty. Ass’n, 140 P.3d 351, 354 (Colo. App. 2006) (trial court improperly retrospectively applied prospective statute when cause of action accrued before effective date of statute). Nonetheless, because the error does not affect the substance of the trial court’s order, we affirm the order for the reasons discussed below.</p>
<p>	Also, unless otherwise noted, all citations refer to these statutes as they existed in time of  Lucia’s death.</p>
<p>II.</p>
<p>Our review of the grant of summary judgment is de novo. See A.C. Excavating v. Yacht Club I Homeowners Ass’n, 114 P.3d 862, 865 (Colo. 2005).<br />
Statutory interpretation is a question of law we review de novo. Klinger v. Adams County Sch. Dist. No. 50, 130 P.3d 1027, 1031 (Colo. 2006). When we interpret a statute, our task is to determine and give effect to the legislature’s intent. Colo. Ofice of Consumer Counsel v. Pub. Utils.Comm’n, 42 P.3d 23, 27 (Colo. 2002). When determining legislative intent, we look to the language of the statuteitself and give effect to the statutory terms in accordance with their commonly accepted meaning. Winscom v. Garza, 843 P.2d 126, 128 (Colo. App. 1992). In so doing, we construe the statute as a whole in an effort to give consistent, harmonious, and sensible effect to all of its parts in accordance with the presumption that the legislature intended the entire statute to be effective. Minh Le v. Colo. Dep’t of Revenue, ___ P.3d ___, ___ (Colo. App. No. 07CA0729, May 29, 2008). Furthermore, in construing the different statutory provisions concerning the same topic or having the same general purpose, we must give effect to the legislative purpose of all such provisions. See Walgreen Co. v. Charnes, 819 P.2d 1039, 1043 (Colo. 1991).</p>
<p>Finally, the interpretation of an insurance policy presents a question of law we review de novo. Massingill v. State Farm Mut. Auto. Ins. Co., 176 P.3d 816, 820 (Colo. App. 2007).</p>
<p>III.</p>
<p>Survivors are not entitled to recover under their own UM/UIMpolicy for the death of a person who is not an insured under that policy. See Farmers Ins. Exch. v. Chacon, 939 P.2d 517, 522 (Colo. App. 1997). Thus, in order to succeed on their claim, the Meza defendants must show that the exclusion in the American Family policies was void, and that Lucia qualified asan insured pursuant to this statute.</p>
<p>We conclude that under the statutory scheme in effect at the time of the accident, Lucia qualified as an insured person. Hence, the limited definition of “relative” in American Family’s insurance policies was in contravention of the intent of the UM/UIM statute at the time those policies were issued.</p>
<p>A.<br />
By enacting the UM/UIM statute, the General Assembly intended to protect the public from “the devastating financial loss that a traffic accident victim can incur.” It provided a mechanism through which an insured could purchase insurance coverage against such a loss. Aetna Casualty &#038; Surety Co. v. McMichael, 906 P.2d 92, 98 (Colo. 1995); see § 10-4-702.</p>
<p>Accordingly, “insurers must offer UM/UIM coverage to a class of insureds coextensive with the class of insureds covered under the liability provision of the policy.” Aetna Casualty, 906 P.2d at 98 (emphasis added). This requirement implements the legislative intent to encourage thewidespread availability of UM/UIM insurance. Id.</p>
<p>B.<br />
Because UM/UIM coverage must be offered to the class covered under the liability provisions, we must begin our discussionwith what coverage is mandated under the liability provisions.</p>
<p>If an insurance policy dilutes, conditions, or limits statutorily mandated liability coverage, it is void and unenforceable. Massingill, 176 P.3d at 820 (citing DeHerrera, 30 P.3d at 173). Insurers may limit coverage only so long as public policy is not violated. Winscom, 843 P.2d at 128. “Thus, if a person seeking coverage is one for whom coverage is required by statute, an insurer cannot limit its statutory obligation by a contractual provision contrary to the requirements of the No-Fault Act.” Finizio v. American Hardware Mut. Ins. Co., 967 P.2d 188, 190 (Colo. App. 1998).</p>
<p>Here, by the policies’ terms, the identical definitions of “relative” and “insured” in the American Family defendants’ policies applied to both liability coverage (required by the No-Fault Act) and UM/UIM coverage. Thus, if the policy definitions of “insured “ and “relative” improperly narrow the class of insureds that is statutorily mandated for liability coverage, the same definitions in the UM/UIMpolicy must necessarily violate public policy. </p>
<p>The issue here is whether the definition of “insured” in the policies, which places limitations on which relatives may be insureds, conflicts with the statutorily mandated liability coverage under the No-Fault Act. Wheeler v. Allstate Ins. Co., 814 P.2d 9, 10 (Colo. App. 1991) (motor vehicle insurance agreements are governed by the No-Fault Act, which is controlling in the event of a conflict between the two).</p>
<p>The statutory classification of persons to whom liability coverage must be extended was codified at section 10-4-703(6). Finizio, 967 P.2d at 190; Winscom, 843 P.2d at 128; see Wiglesworth v. Farmers Ins. Exch., 917 P.2d 288, 290 (Colo. 1996).Under section 10-4-703(6), insureds were defined, as pertinent here, as “relatives of the named insured who reside in the same household as the named insured.” Accordingly, the No-Fault Act required liability coverage for this class of individuals. See Finizio, 967 P.2d at 190 (insurers cannot contractually limit statutorilymandated coverage).<br />
Yet in all three policies of the American Family defendants, the insurers contractually limited the class of persons who would qualify as a ‚”relative.” The pertinent provisions of the American Family defendants’policies all stated as follows: “Relative means a person living in your household, related to you by blood, marriage or adoption. . . . It excludes any person who, or whose spouse, owns a motor vehicle other than an off-road motor vehicle.”</p>
<p>These provisions “improperly narrow the class of insureds” to whom the American Family defendants were required to provide liability coverage under the No-Fault Act. See Finizio, 967 P.2d at 190 (because statute mandated coverage for permissive users, policy improperly limited coverage to those permissive users who did not have liability coverage of their own or who had other liability insurance available less than statutory minimum limits under No-Fault Act). The American Family policies improperly excluded from statutorily mandated liability coverage those otherwise qualified relatives who own, or whose spouses own, vehicles. Because this definition diluted, conditioned, and limited statutorily mandated liability coverage under the No-Fault Act, it is void and unenforceable. Massingill, 176 P.3d at 820; see Finizio, 967 P.2d at 190 (insurer cannot limit statutory obligation by contractual provision contrary to requirements of No-Fault Act).</p>
<p>Because liability coverage is legally required for relatives residing in the named insured’s household, UM/UIM coverage mustextend to these relatives as well. The only permissible limitation is where a policyholder expressly contracts for narrower UM/UIM coverage than that mandated under his liability coverage. See Bernal v. Lumbermens Mut. Casualty Co., 97 P.3d 197, 200 (Colo. App. 2003) (the policyholder may reject or limit UM/UIM coverage). Such is not the case here. By their terms, the American Family policies provided UM/UIM coverage coextensive with liability coverage. But because the liability coverage in the policies improperly limited statutorily mandated coverage, the policies likewise improperly limited UM/UIM coverage of relatives based on the ownership of a vehicle. Because the policies limited statutorily mandated coverage and thus violate public policy, the “relative” exclusion is void. Massingill, 176 P.3d at 820; see Winscom, 843 P.2d at 128 (insurers may limit coverage only if public policy is not violated).<br />
IV.<br />
The American Family defendants contend that the definition of “relative” in the policies is akin to the valid named driver exclusion in Massingill. We disagree. The exclusion there was allowed by statute for named individuals based on their driving records. Massingill, 176 P.3d at 820 (named driver exclusions permitted in motor vehicle insurance policies under former § 10-4-721 and under § 10-4-630, C.R.S. 2007). Here, the limitation placed on the class of people covered by the liability provisions is not provided for by statute.</p>
<p>We also note that the fact that the legislature expressly placed limits on liability coverage in certain circumstances suggests that the General Assembly did not so intend here. See Nat’l Farmers Union Property &#038; Casualty Co. v. Estate of Mosher, 22 P.3d 531, 534 (Colo. App. 2000) (court not at liberty to read additional terms into or modify plain language of statute where General Assembly has elsewhere enacted limitation urged upon the court). Also, the American Family defendants’ reliance on section 42-7-4 13, C.R.S. 2007, as codifying the class of persons to whom liability coverage must extend, is misplaced. That statute by its own terms limits itsapplication to the Motor Vehicle Responsibility Law. See also Wheeler, 814 P.2d at 10 (motor vehicle insurance agreements are governed by No-Fault Act).</p>
<p>In addition, we distinguish the American Family defendants’ supplemental authority, Pacheco v. Shelter Mut. Ins. Co., (D. Colo. No. 06-cv-01 165-JLK-BNB, Jan. 23, 2008) (unpublished order on pending motions). There, the court reasoned that because the<br />
claimant was not an insured under either the UM/UIM or liability provisions of the policy, the exclusion in the UM/UIM policy did not violate the statutory intent that UM/UIM coverage be coextensive with the coverage provided in the liability provision of the policy. The court did not analyze the enforceability of the liability exclusion.</p>
<p>Finally, we conclude the foreign authorities relied on by the American Family defendants are not instructive here. Several of the cases are inapposite because the applicable statutes either did not mandate coverage of relatives, mandated narrower coverage than the Colorado statute, or did not define the class to which coverage must extend. American Family Mut. Ins. Co. v. Cranston, 1989 WL 58963 (D. Kan. No. Civ. A. 88-403 1, May 9, 1989) (unpublished memorandum and order); Middlesex Ins. Co. v. Quinn, 622 A.2d 572(Conn. 1993); Indiana Lumbermans Mut. Ins. Co. v. Vincel, 452 N.E.2d 418 (Ind. Ct. App. 1983); Lewis v. American Family Ins. Group, 555 S.W.2d 579 (Ky. 1977); Washington v. Travelers Ins. Co., 284 N.W.2d 754 (Mich. Ct. App. 1979); Malo v. Aetna Casualty &#038; Surety Co., 459 A.2d 954 (R.I. 1983); Farmers Ins. Co. v. Miller, 549 P.2d 9 (Wash. 1976). In the remaining cases, the issues presented to the court were substantially different from the issue presented here. American Family Mut. Ins. Co. v. Kittinger, 498 N.E.2d 256 (Ill. App. Ct. 1986) (UM coverage does not extend to financially irresponsible relative who cancelled her own car insurance policy); Ellis v. American Family Mut. Ins. Co., 750 N.E.2d 1287 (Ill. App. Ct. 2001) (effect of judicial admission that claimant owned vehicle); Burkett v. American Family Ins. Group, 737 N.E.2d 447 (Ind. Ct. App. 2000) (court’s holding relied on whether definition of ‚relative₤in policy was ambiguous); Smitke v. Travelers Indem. Co., 118 N.W.2d 217 (Minn. 1962), (objective of UM statute was to provide coverage to resident relatives who could not obtain such coverage inany other way); McKee v. American Family Mut. Ins. Co., 932 S.W.2d 801 (Mo. Ct. App. 1996) (issue was whether van owned by resident relative was motor vehicle under insurance policy).</p>
<p>V.<br />
In light of our conclusion, we need not decide whether the trial court erred in characterizing the exclusion as a “vehicle exclusion.” </p>
<p>We affirm the order of the trial court, albeit on different grounds. Steamboat Springs Rental &#038; Leasing, Inc. v. City &#038; County of Denver, 15 P.3d 785, 786 (Colo. App. 2000) (appellate court may affirm a trial court’s correct judgment based on different reasoning).</p>
<p>Order affirmed.<br />
JUDGE VOGT and JUDGE GRAHAM concur.</p>
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