In this week’s notable decision, Advanced Physicians, S.C. v. Connecticut General Life Insurance Company, et al., No. 3:16-CV-2355-G, 2020 WL 58698 (N.D. Tex. Jan. 3, 2020), a district court in Texas held that the fiduciary exception to the attorney-client privilege prohibits Cigna from withholding privileged documents from a medical service provider related to Cigna’s alleged wrongful denial of insurance claims under the NFL Player Insurance Plan (“Plan”).

By way of background, Advanced Physicians (“AP”) alleged that Defendant Great-West Healthcare-Cigna (“Cigna”), which has discretionary authority to make coverage decisions under the Plan, began wrongfully refusing to pay any of AP’s claims for services that it provided to retired NFL players.  Advanced Physicians, S.C. v. Connecticut Gen. Life Ins. Co., 2017 WL 4868180 (N.D. Tex. Oct. 27, 2017).  The court previously dismissed AP’s claim for relief under ERISA Section 502(a)(3) but permitted its claim for benefits under ERISA Section 502(a)(1)(B) to proceed.  Advanced Physicians S.C. v. Connecticut Gen. Life Ins. Co., No., 2018 WL 1509120, at *3 (N.D. Tex. Mar. 27, 2018).
Continue Reading In NFL ERISA Suit, Court Finds Fiduciary Exception to Attorney-Client Privilege Applies to Cigna’s Privileged Documents

I’m pleased to report that this week’s notable decision is a gem of a discovery decision obtained by our firm in the matter of Gray v. Unum Life Insurance Company of America, et al., No. 17-1778-JGB-KKx (C.D. Cal. Sept. 21, 2018) (unreported).  Plaintiff alleged that Unum wrongfully terminated her long term disability benefits under the Boy Scouts of America Long Term Disability Plan.  Plaintiff filed a motion to compel responses to discovery requests aimed at ascertaining Unum’s business practice of forecasting and targeting disability claims for potential “recoveries” or terminations.  

The court granted Plaintiff’s motion to compel Unum to respond to Requests for Production, Nos. 2-5, which seek the following:

• Request No. 2: “All Weekly Tracking Qtr. View Reports for claims within the same Unit(s) to which THE CLAIM was assigned during the time period of May 30, 2016 through and including October 30, 2017.”
Continue Reading Court Compels Unum to Produce Information About Its Alleged Forecasting and Targeting of Disability Claims for Termination