The attorneys on our Life, Health & Disability Litigation Team have decades of experience litigating a range of disputes, including:

• Joseph v. Northwestern Mutual Life Insurance Co., Middle District of Georgia
  Represented insurer in case addressing whether insured under individual disability income insurance policy failed to comply with policy’s notice of claim provision.
• Royal v. New York Life Ins. Co., Southern District of Georgia
  Handled matter for insurance company involving claim that the insured under an individual disability income insurance policy failed to comply with policy’s 90-day proof of loss provision and three-year legal actions provision.
• Smith v. Cox Enter., Inc., Northern District of Georgia
  Served as counsel for the administrator of a self-funded ERISA plan in a matter hinging on whether the plan administrator abused its discretion in denying claim for disability benefits.
• Dorsey v. Aetna Life Insurance Co., Eastern District of Virginia
  Handled matter for insurance company involving whether self-funded plan was top hat plan exempt from disclosure obligations of Section 104(b)(4) of ERISA and whether third-party administrator abused its discretion in denying claim for disability benefits.
• Medical Center, Inc. v Humana Military Healthcare Services, Middle District of Georgia
  Represented TRICARE managed care support contractor in case involving whether it properly offset amount of overpayments for medical claims against future claim payments owed to hospital.
• Burnett v. Combined Insurance Company of America, Middle District of Georgia
  Served as counsel to insurance company in case hinging on the question of whether a second disabling injury sustained during period of continuous total disability entitled insured to a new maximum benefit period.
• Muhammad v. Humana Dental Insurance Co., Northern District of Georgia
  Handled litigation for dental insurer examining the question of whether a claim for breach of dental insurance contract was preempted by ERISA.
• Provident Life and Accident Insurance Co. v. Futch, Southern District of Georgia
  Represented insurance company in case involving the question of whether a surgeon was eligible to recover lifetime disability benefits based on claim that bilateral osteoarthritis of the hips was due to accidental bodily injuries, rather than due to sickness.
• White v. New York Life Insurance Co., Southern District of Georgia
  Represented insurer in matter involving whether a lapse of life insurance policy for failure to pay premiums was excused by insured's alleged mental incapacity.
• Le Roux v. Woodgrain Millwork, Inc., District of Idaho
  Handled matter for self-funded health benefits ERISA plan involving whether claims against the plan for equitable estoppel, breach of fiduciary duty, and class action were subject to dismissal under Fed. R. Civ. P. 12(b)(6).
• Mitchell v. Globe Life and Accident Insurance Co., Northern District of Georgia
  Represented insurer in litigation over whether the beneficiary under an accidental death insurance policy timely complied with notice of claim and proof of loss provisions of policy and established accidental death within meaning of policy.
• Cowart v. Metropolitan Life Insurance Co., Middle District of Georgia
  Served as counsel for insurance company in case addressing question of whether individual disability policy was part of ERISA plan or came within Department of Labor “safe harbor,” in view of evidence that employer paid premiums.
• Karp v. Guardian Life Insurance Company of America, Southern District of Georgia
  Represented insurer in litigation involving whether termination of disability benefits under ERISA plan or award of Social Security disability benefits was a “qualifying event” requiring former employer to offer continuation of health insurance under COBRA.
• Moorman v. UnumProvident Corp., 11th Circuit
  Served as counsel to employer in matter addressing the question of whether a disability insurance plan was “established and maintained” by employer and therefore governed by ERISA, and whether plan satisfied safe harbor exemption from ERISA based on actions of employer.
• Powers v. Paul Revere Life Insurance Co., Northern District of Georgia, affirmed 11th Circuit
  Represented insurance company in matter involving whether a letter to insured from insurance agent amended disability policy to add cost of living benefits.
• Kocer v. New York Life Insurance Co., Northern District of Georgia
  Provided representation to insurer in matter hinging on whether disability benefits were payable to physician whose license to practice medicine was revoked, thereby resulting in “legal disability” before the onset of factual disability.
• Dixon v. Life Insurance Company of North America, 11th Circuit
  Handled matter for insurance company involving whether death resulted “directly” from accident and “no other causes” where insured’s preexisting cardiac condition substantially contributed to automobile accident resulting in death.
• Transamerica Occidental Life Insurance Co. v. Miles
  Represented insurer in matter involving whether term life insurance policy went into effect where application required owner's personal receipt of policy while in good health and applicant's health changed after policy was received by agent, but before policy was delivered to applicant.
• Worsham v. Provident Companies, Inc., Northern District of Georgia, affirmed 11th Circuit
  Served as counsel to insurance company in case addressing the question of whether the merger clause of disability policy barred plaintiff's fraud and RICO claims based on representations allegedly made by agent.
• Yessick v. Midland Life Insurance Co., Northern District of Georgia
  Provided representation to insurer in case involving whether proof of customary, computerized procedures was sufficient to establish that premium invoice and lapse notice were mailed to insured.
• McAfee v. Transamerica Occidental Life Insurance Co., Northern District of Georgia, affirmed 11th Circuit, cert. denied
  Represented insurance company in matter involving whether insured’s death in shootout with police was covered under accidental death insurance policy.
• Suarez v. Massachusetts Mutual Life Insurance Co., Northern District of Georgia, affirmed 11th Circuit
  Handled matter for insurer involving question of whether loss of medical license was legal disability, precluding recovery of disability benefits based on subsequent factual disability.
• Adair v. Boston Mutual Life Insurance Co., Middle District of Georgia
  Represented insurance company in litigation over whether insured’s death from apparent medication overdose was by accidental means.
• Cosby v. Transamerica Occidental Life Insurance Co.
  Served as counsel to insurance company in case involving issue of whether insured's breach of common law duty to advise insurer of change in health warranted rescission of life insurance policy.
• Griffin v. Humana Employers Health Plan of Georgia, Inc., Northern District of Georgia, affirmed 11th Circuit
  Provided representation in case involving question of whether the Medicare Secondary Payer Act private cause of action permits a Medicare Advantage Organization to sue a primary payer that refuses to reimburse the MAO for a secondary payment.
• Counseled client in case addressing whether a national Medicare Managed Care insurer owed $20 million on a risk contract with a managed services organization in South Florida.
• Handled matter involving issue of whether a large insurer in a confidential arbitration owed a $5 million contract claim made by a managed services organization, and whether the managed services organization’s new plan improperly enrolled the payor’s members.