This case involved a claim for accidental death benefits following a fatal motor vehicle accident. LINA denied benefits, asserting that the death was not accidental due to alleged foreseeability and risk-taking conduct. During litigation, LINA attempted to defend the denial using arguments and theories that were not raised during the administrative claims process. Kantor & […]
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Collier v. Lincoln Life Assurance Co. of Boston
The claimant sought ERISA life insurance benefits after Lincoln Life denied a claim following a death. The denial left the beneficiary without payment under a policy intended to provide post-loss financial protection. In litigation, Lincoln Life attempted to defend its decision using explanations that were not fully articulated in the administrative denial. Kantor & Kantor […]
Orzechowski v. Boeing Co. Non-Union Long-Term Disability Plan
Kantor & Kantor represented a claimant whose long-term disability benefits were denied under a Boeing-sponsored ERISA plan administered by Aetna. The denial placed the claimant’s income and financial stability at risk despite prior approval of benefits. The plan defended the denial under a deferential standard of review based on discretionary language embedded in the policy. […]
Harlick v. Blue Shield of California
The claimant was diagnosed with anorexia nervosa and required residential mental health treatment after outpatient and partial hospitalization care proved inadequate. Blue Shield denied coverage while continuing to cover analogous inpatient medical services. Blue Shield relied on plan exclusions to deny residential mental health treatment despite medical necessity and despite parity protections under California law. […]
Harlick v. Blue Shield of California
The claimant sought coverage for residential mental health treatment after being diagnosed with anorexia nervosa. Her treating physicians determined that outpatient and partial hospitalization care had failed and that residential treatment was medically necessary to address the severity of her condition. Blue Shield denied coverage and issued a denial letter that relied on specific policy […]
Dine v. Metropolitan Life Insurance Co.
Kathy Dine received long-term disability benefits under an ERISA-governed plan after medical conditions rendered her unable to continue working. Her treating physicians continued to document functional limitations that interfered with sustained, full-time employment. MetLife terminated benefits, asserting that Dine no longer met the plan’s disability definition. MetLife both evaluated claims and paid benefits under the […]
LeGras v. Aetna Life Insurance Co.
Andre LeGras sought continued disability benefits and pursued an administrative appeal after receiving a denial. The appeal deadline fell on a weekend, and Aetna treated the appeal as untimely, asserting that the missed deadline barred judicial review of the claim. Kantor & Kantor challenged Aetna’s rigid deadline interpretation and argued that ERISA exhaustion requirements are […]
Rorabaugh v. Continental Casualty Co.
Willow Rorabaugh worked as a Branch Office Administrator, a position requiring sustained sitting, frequent hand use, bending, twisting, and postural tolerance. She underwent back surgery for spinal stenosis in April 2003 and initially received short-term disability benefits. Her recovery was complicated by progressive neurological symptoms, including gait disturbance, rigidity, fatigue, and tremors. Neurology evaluations resulted […]
Shane v. Albertson’s Inc.
Stacey Shane began receiving long-term disability benefits after a knee injury prevented her from continuing her job duties. Benefits were approved and paid for an extended period under the plan in effect at the time her disability began. After a later recertification process, Albertson’s terminated benefits and denied her appeal. The plan argued that later […]
Welch v. Metropolitan Life Insurance Co.
Welch filed suit challenging MetLife’s denial of long-term disability benefits. Approximately six months after litigation began, MetLife paid the claim in full, converting the case into a dispute over attorney’s fees incurred to obtain payment. The district court substantially reduced the fee award, lowering hourly rates and imposing across-the-board reductions based on billing practices. The […]
