On March 5, 2019, Magistrate Judge Joseph C. Spero of the U.S. District Court for the Northern District of California issued his opinion in Wit v. United Behavioral Health, in which he attempted to significantly change how...more
In this week’s episode, Gary Qualls discusses a recent case decided in the Western District of Louisiana, which highlights how the application of the arbitrary and capricious standard as applied to payor coverage...more
Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more
Even when a claims administrator approves a claim for disability benefits, its job is not done. That principle was again demonstrated in the recent case Owings v. United of Omaha Life Insurance Co., No. 16-3128 (10th Cir....more
The Holding - In Preciado v.Young American Insurnace Company, 2017 WL 2805631 ( Ariz.App . June 29, 2017) (unpublished), the Arizona Court of Appeals held the trial court erroneously failed to grant an Insurer’s motion for...more
In Hartford Accident and Indemnity v. Crum & Forster Specialty Insurance et al., the Eleventh Circuit recently reversed a District Court’s decision refusing to vacate its prior judgments even though vacatur was a condition of...more