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Don Levit 11/17/2008 01:47 PM
Brian: Thanks for providing this very interesting case. It seems to me that the decision would be a "slam dunk" (go Rockets, beat the Jazz)! Can you share with us why the district court ruled otherwise? Because the Loren Cook plan was self-funded, did that have anything to do with their contesting the claim? I am curious what the relationship is like now between Bob Quaid and his employer? Don Levit
Brian S. King 11/17/2008 01:47 PM
Hi Don-- My apologies for not responding to your comment sooner. First, sorry about your Rockets. But we're having a fun ride with the Jazz right now. We'll see how they do against the Spurs. The district court ruled against us based on its reading of the statute. Loren Cook argued that they treated Skylar no differently than his siblings would have been treated if they had been adopted with coverage through the birth parents' HMO: they would have denied the siblings any coverage too. I was quite surprised when we lost at the trial court level because we have always felt this was a strong case and our trial judge has an excellent reputation for brains, hard work, and objectivity. But you never know when you put these cases in the hands of a judge or jury. Sometimes you lose some strong cases that you can't believe you lost and win some relatively weak ones. Like the great majority of my cases, we are doing this on a contingent fee. It's been in the litigation process since about 2000 or 2001. We've got a lot of time and costs in it that the firm would have just absorbed if we'd lost. It's a true entrepreneurial endeavor. Given that, it's a wonder why the business community doesn't like contingent fee lawyers more. As for the self-funded angle, I'm not sure that had too much to do with things. Loren Cook had stop loss insurance and I know that the Plan and the stop loss insurer have some sort of arrangement to allocate the loss between them but I'm not privy to the details on that. I don't know who, as between the Loren Cook company and the stop loss insurer, is the decision maker about how the case was defended. Finally, as for the relationship between Bob and Loren Cook, the company closed the plant they had here in Utah sometime in 2001 or 2002 and Bob was laid off. I don't think Loren Cook hassled Bob about him pursuing his claim. That is both to its credit and a reflection of the fact that ERISA specifically makes it unlawful to take any puniitive action against a plan participant who takes legal action to enforce their rights under ERISA. Thanks for your interest Don!
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