Life, Health & Disability Insurance & ERISA Litigation

Representative Matters

• The entire HMO system in California was on trial in a significant lawsuit for our client Blue Shield. At issue was whether the state’s health plans can be held responsible for decisions they delegate to medical groups. We prevailed before a Los Angeles jury at trial, while also blocking filmmaker Michael Moore from turning the jury trial into a circus. The California Court of Appeal subsequently handed down a unanimous opinion, adopting our legal arguments and making new law in California.  
•  We defended ReliaStar Life Insurance Company in a class action alleging that the drug exclusion in our client’s group accidental death and dismemberment policy did not comply with California law and therefore could not be used to deny claims for accidental death benefits submitted by California insureds. We settled the case on favorable terms after the court refused to certify a class.
•  We obtained summary judgments (affirmed on appeal) on behalf of Metropolitan Life Insurance Company in 17 “vanishing premium” cases in which plaintiffs claimed they were misled by misrepresentations that the dividends on their life insurance policies would be sufficient to pay all future premiums after they had paid premiums out of pocket for a specified number of years.
• We recovered substantial attorneys’ fees for Monumental Life Insurance Company—as well as most of the accidental death insurance proceeds—in the infamous “Black Widows” case in which two elderly women befriended homeless men, took out accidental death insurance on them, named themselves as the beneficiaries, and then murdered them.  
• We represented Blue Shield of California in a significant RICO action brought by a nationwide class of 900,000 physicians.  The suit alleged that plans throughout the country had engaged in a RICO conspiracy to underpay physicians. Most of the defendant insurers settled for hundreds of millions of dollars in cash payments to the class, plus commitments to make significant business changes over a multiyear period. Our client did not settle, and the District Court subsequently granted our motion to dismiss with prejudice.
• We defended SwissRe in a coverage action involving Catholic archdiocese priest molestation claims involving hundreds of priests over a 40-year period. That case was settled on very favorable terms for our client.
• On behalf of a New York health plan, we challenged the New York Insurance Department’s denial of proposed reconfiguration of our health insurer client’s rating region and obtained an order from the New York State Supreme Court requiring the Department to grant our client’s request.
• With only months to go before trial, SwissRe asked us to help design and lead a defense trial strategy against allegations that the company was liable for covering thousands of asbestos injury-related claims. Soon after we appeared in the case, the opposing side agreed to discuss settlement, and the matter was successfully resolved for our client.
• We defended and reached a mutually agreeable settlement of a lawsuit arising out of the death of actor Heath Ledger that challenged an insurer’s right to conduct a contestable investigation.  
• We currently advise the largest workers’ compensation carrier in California on corporate indemnification issues and coverage claims under its own directors and officers liability policies.