Mar 23, 2019

DISCLAIMER: The results are specific to the facts and legal circumstances of each of the clients' cases and should not be used to form an expectation that the same results could be obtained for other clients in similar matters without reference to the specific factual and legal circumstances of each client's case.

Disability and Life Insurance Claims

• Reversing a Disability Denial Based on Seizures and Traumatic Brain Injury

Awarded: $115,000 Disability Claim

Medical Claims

• Suit Based on Inaccurate Insurance Verification is Not Preempted by ERISA

Awarded: Suit Based on Inaccurate Insurance Verification is Not Preempted by ERISA

• Teen Help, Inc. v. Operating Engineers Health & Welfare Trust Fund

Awarded: Medical Criteria Must Be Produced Upon Request

• Hernandez v. Prudential Ins. Co. of America

Awarded: Second Decision Requiring Production of Medical Necessity Criteria

• University of Utah Hospital v. Educators Mutual

Awarded: $335,000 arbitration award

• Rescinded Insurance Policy

Awarded: Reversing an Insurer's Rescission of Policy

• Payment of Rehabilitation Claim

Awarded: Award of Over $35,000 on Rehabilitation Claim

• Resolving Disputes Involving Managed Care Contracts

Awarded: Managed Care Contracts

• Medical Necessity of Orthognathic Surgery

Awarded: $33,934.88 plus prejudgment interest

Miscellaneous

• Peay v. BellSouth Medical Assistance Plan

Awarded: Jurisdiction & Venue in ERISA

• Haymond v. Eighth District Electrical Benefit Fund

Awarded: Ambiguous ERISA plan documents

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