Our Results

  • Chronic Fatigue Syndrome

    Kantor & Kantor represented a cameraman who suffered from chronic fatigue syndrome and was unable to perform the duties of his occupation. His claim was denied by his disability insurer, who failed to conduct any meaningful investigation of the claim.

    Kantor & Kantor, LLP filed suit and after a brief period of discovery filed a motion for summary judgment, requesting the Court to enter judgment in the plaintiff's favor without a trial, and as a matter of law. The Court granted our motion for summary judgment. As a result, our client received all benefits under his policy up to age 65, a significant amount of damages for emotional distress, and payment for his attorneys' fees, for a total of over $900,000.

  • Eating Disorders

    Our client came to Kantor & Kantor, LLP after unsuccessfully seeking treatment from Kaiser for a severe eating disorder (bulimia). For four months, she tried to obtain appropriate treatment, but Kaiser offered only inconsistent appointments with unqualified personnel. Without appropriate treatment, her condition worsened and she became suicidal. Even at that point, Kaiser advised our client that there was no appropriate treatment program available within the Kaiser system. Our client’s family researched the question and found a program that was designed specifically to treat the condition. Pursuant to the terms of her Plan, our client requested Kaiser to authorize a referral to that program, and that Kaiser pay for her treatment. Kaiser refused.

    Fearful for her daughter's life, our client's mother arranged to admit her to the program at the family’s expense. Our client remained in a special facility as an in-patient for about a month. On appeal, Kaiser upheld its denial of the claim, and never even responded to our client's request for a list of available providers within the Plan.

    Based on our lawsuit, the court held that Kaiser's behavior was wrongful, unreasonable, irrational, and contrary to the evidence, the terms of the Plan and applicable law. Kaiser was further ordered to pay all fees and costs of our client's treatment, and attorney’s fees and costs related to the litigation.

  • Fibromyalgia

    Kantor & Kantor, LLP represented a Customer Care Advocate who suffered from fibromyalgia. Plaintiff's job was largely sedentary, requiring that she sit at her desk for nearly all the work-day. After several short-term disability leaves, the plaintiff filed for long-term benefits. Despite reports from her doctor indicating that she was unable to perform her job duties, the plaintiff's claim was denied. Plaintiff appealed this decision, included additional doctor's reports and statements from family and friends describing her deteriorating physical condition, but was repeatedly denied benefits.

    The Court, after a de novo review of the defendant's denial, overruled the defendant's administrative decision, entering judgment for the plaintiff. Plaintiff's long-term disability benefits were resumed and the defendant was ordered to pay the plaintiff's attorney fees.

  • Lupus

    Our client, Mrs. Wible, was an employee of The Boeing Company. She came to Kantor & Kantor, LLP for help in obtaining Long Term Disability (LTD) benefits from Aetna. While employed, Mrs. Wible became totally disabled due to Lupus, and was thus entitled to benefits under the LTD Plan of the Boeing Company.
    Her claim was initially paid by Aetna, but was then later denied. Mrs. Wible appealed the denial. Tragically, while the appeal was pending, Mrs. Wible died from complications of her Lupus.

    Incredibly, even though Mrs. Wible died as a result of Lupus within just six months of the date that Aetna determined she was no longer disabled, Aetna denied her appeal post-mortem. We succeeded in getting a Court order stating that Aetna ignored, or at best, discounted the credible evidence of her disability. That evidence included the opinions of Mrs. Wible's long-time treating physician, Aetna's own physician who reviewed Mrs. Wible's file, Aetna surveillance evidence and the Social Security Administration findings of Mrs. Wible's disability. The Court found that Aetna was "bent on denying" Mrs. Wible's claim and oblivious to its fiduciary obligations as an LTD Plan administrator.

    Aetna paid 100% of all benefits and attorneys fees.

  • Life Insurance

    Hartford Insurance Company offered a supplemental life insurance program to the employees and their families of Sargent Fletcher. Our client, Donald Gaines signed up for Supplemental Life Insurance, purchasing coverage for his wife. The life insurance premiums were deducted from his paycheck for five months and transmitted to Hartford. After five months, Mrs. Gaines passed away unexpectedly and Mr. Gaines filed a claim for the benefits. Hartford denied Mr. Gaines’ claim, stating that the employer failed to submit the proper paperwork when it enrolled its employees in the life insurance plan.

    We brought suit against both the employer and Hartford and we were successful in obtaining a verdict in our client’s favor. The trial court held that the policy was ambiguous as to what type of paperwork was required to be submitted to properly enroll in coverage and that after accepting premiums, the insurer could not deny the claim. Gaines v. The Sargent Fletcher, Inc. Group Life Ins. Plan, 329 F.Supp2d 1198 (C.D., Cal., 2004).

  • Multiple Sclerosis
    Ms. Gullidge was a former Title Examiner for First American Title and participated in her employer’s long term disability plan. Ms. Gullidge was diagnosed with Multiple Sclerosis in the early 1980's, but continued to work until 2002. She submitted a claim for disability benefits due to her progressive weakness and fatigue. Hartford Insurance Company approved of plaintiff’s claim and Ms. Gullidge was also awarded Social Security disability benefits. Hartford then sent a confusing letter to Ms. Gullidge’s physician, asking him if Ms. Gullidge could perform “sedentary work,” even if she could only sit for less than 3 hours a day. The physician misunderstood the letter and then later corrected his statement and advised Hartford that Ms. Gullidge was absolutely disabled. Hartford refused to accept the correction and terminated plaintiff’s benefits.
    After litigating the case for several months, Hartford unilaterally decided to reverse its claim decision and reinstated Ms. Gullidge to her benefits.

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