Category: Health Benefit Claims
CIGNA Accused of Underpaid Benefits
One tool that can be effective in correcting unfairness with underpaid medical benefit claims is the class-action. An example can be seen in the recent class action filed in the United States District Court for the District of Connecticut, Stewart
Is Lipedema Liposuction Covered by Insurance?
We are commonly encouraged to do what we can to stay fit, but not everyone’s weight is within their control. Today, we’re highlighting a recent case which addressed the question: “Is lipedema liposuction covered by insurance?” What is Lipedema? Some
Can an ERISA Medical Plan Sue My Law Firm?
So, you settled a personal injury lawsuit. An ERISA medical benefits plan previously put you on notice that it had paid medical expenses. The subrogation demand is a significant portion of the settlement. Do you have to pay the plan
Unsafe Workplace Conditions & the ERISA Shield
Being a home healthcare nurse can be a very challenging job. Deanna Pierce knows that all too well. She is also familiar with the ERISA games played by employers relating to an unsafe workplace environment. Sometimes those games are inappropriate
Proton Therapy Insurance Denial – What is it and why?
Cancer is at the root of many claims relating to one’s ability to work, such as ADA claims and medical benefits claims. A frequent reason for denying medical benefit claims is a lack of medical necessity, another is that a
The Attempted Murder of a COBRA Class Action Claim
Many employers may require an employee to sign an arbitration clause as a condition of employment or as a condition for receiving benefits. Starbucks is one of those companies. Given that under ERISA a participant or beneficiary is not entitled
Employer Games: Hide & Seek with Employee Health Benefits
ERISA cases are full of games – games plan administrators play to avoid liability. The latest example from the Middle District of Alabama involves the failure to give notice that the employee has been terminated (which means the employee no
My Retirement Account Tanked – What Can I Do?
This is something that many will ask given the hit that the market has taken as the result of COVID-19. But it goes beyond that. It is of critical importance to employees who are approaching retirement age and affects people
What is the Turning Point of Your ERISA Case?
The outcome of many ERISA cases can often turn on one key fact. Mr. Sulyma experienced that in his ERISA case, as handed down by the U.S. Supreme Court in a recent case, Intel Corp. Investment Policy Committee v. Sulyma.
Workers Comp & Long-Term Disability: Entitled to Both?
One question that we often hear is whether someone who has been hurt on-the-job is entitled to long-term disability benefits in addition to workers’ compensation benefits. Workers’ compensation benefits only cover injuries occurring in the workplace, and many times, people