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Successful Results in ERISA Claims

Oster v. Standard Ins. Co., -- F.Supp.2d --, 2011 WL 31110 (N.D. Cal. 2011)

Pillsbury & Levinson won a federal court decision on behalf of a claimant suffering a brain traumatic injury caused by an auto accident. The trial court held that the insurer improperly denied benefits by using biased medical reviewers and by ignoring the medical evidence showing cognitive deficits. The trial court awarded past benefits owed, prejudgment interest and Pillsbury & Levinson’s full attorney’s fees.

Martorello v. Sun Life Assur Co. of Canada, 704 F. Supp. 2d 918 (N.D. Cal. 2010)

Pillsbury & Levinson convinced the trial court that the insurer improperly denied the claimant disability benefits by improperly evaluating the claimant's income, directly contradicting the terms of the insurance policy. Sun Life had originally denied the insured’s claim asserting that the claimant was not longer medically disabled. After Pillsbury & Levinson filed a successful internal appeal, Sun Life refused to pay the benefit, now claiming that he was not entitled to benefits because of their tortured interpretation of his income. court awarded all past benefits owed, and Pillsbury & Levinson settled with the insurer for attorney’s fees and prejudgment interest.

Finkelstein v. Guardian Life Ins. Co., Case No. CV 07-01130 CRB (N.D. Cal. 2009)

Obtained seven-figure settlement in an ERISA case on behalf of an obstetrician/gynecologist who was disabled by a severe orthopedic condition that precluded the performance of many of his most important and most lucrative occupational duties, including the delivery of babies and obstetrical surgery. As a result, he suffered a precipitous drop in income, but continued to work. The insurer argued that because he could still perform many of his former duties, he was not disabled under the policy. P&L obtained a favorable ruling on Motion for Judgment rejecting the insurer's claims, and the case settled shortly thereafter.

Fontana v. The Guardian Life Ins. Co., 2009 WL 73743 (N.D. Cal. 2009)

Pillsbury & Levinson won disability benefits on behalf of a client disabled by Thoracic Outlet Syndrome which made any handwriting or using a computer excruciatingly painful. The trial court held that the insurer improperly refused to consider the medical evidence submitted by the plaintiff, in her internal appeal, ordered the insurance company to reinstate her disability benefits, and awarded all past disability benefits owed plus attorney’s fees.

Moody v. Liberty Life Assur. Co., 595 F.Supp.2d 1090 (N.D. Cal. 2009)

Pillsbury & Levinson convinced the court that the insurer improperly terminated the disability benefits of the plaintiff, who suffered from failed back syndrome after several surgical fusions to the spine.The court held that the insurer relied on biased medical reviewers who ignored the cognitive impairment caused by the plaintiff's pain medications, and found the plaintiff to be totally disabled from his former occupation as a software project manager.

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  1. disclaimer.
What Restrictions Does ERISA Place on Insureds?

Under ERISA, a policyholder may:

  • NOT sue an insurance company for breach
    of the insurance contract
  • NOT sue an insurance company for
    Insurance Bad Faith
  • NOT get a jury trial
  • NOT get any kind of trial in many instances

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