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Peter Sessions

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Peter S. Sessions is a partner at Kantor & Kantor who has been with the firm since 2004. Peter represents individual clients seeking health, life, and disability benefits, typically under employee health plans.

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Williams v. Unum Life Ins. Co. of Am., No. 20-1694, __ F.4th __, 2021 WL 3729660 (8th Cir. Aug. 24, 2021) (Before Circuit Judges Smith, Arnold, and Stras).

Ever since the Supreme Court’s 1989 decision in Firestone Tire & Rubber v. Bruch, ERISA-governed benefit plans and their insurers have sought to grant themselves discretionary authority in order to ensure a favorable standard of review in court.Continue Reading Eighth Circuit Rules Maine’s Anti-Discretion Law Does Not Apply to Accident Policies

Hendricks v. Aetna Life Ins. Co., No. CV 19-06840-CJC(MRWx), 2021 WL 2497950 (C.D. Cal. June 11, 2021) (Judge Cormac J. Carney).

As modern medicine advances, so do health care costs. Health insurers have an incentive to keep those costs down, and one way to do that is to deny claims for benefits by classifying expensive new treatments as “experimental and investigational.”

This case involves plaintiffs’ benefit claims for lumbar artificial disc replacement (“ADR”), a new alternative to traditional spinal fusion. Lumbar ADR has shown promise because it has the potential to provide improved flexibility and mobility to patients with spinal problems. The FDA has approved at least two lumbar disc replacement products, in 2004 and 2006.
Continue Reading Court Certifies Class Action Challenging Aetna’s Benefit Denials for Lumbar Artificial Disc Replacement

Miller v. Reliance Standard Life Ins. Co., No. 20-30240, __ F.3d __, 2021 WL 2221347 (5th Cir. June 2, 2021) (Before Circuit Judges Haynes, Duncan, and Engelhardt).

Continuity of coverage provisions in benefit plans seem fairly straightforward – if you have coverage under your employer’s plan, when your employer switches insurance companies you should still maintain your coverage. However, employees, through no fault of their own, often get tripped up in these transitions and sometimes lose their coverage despite years of service to their employers. In this case, the Fifth Circuit prevented that from happening.
Continue Reading Fifth Circuit Construes Continuity of Coverage Provision in Favor of Disabled Participant