Stratton v. Life Insurance Co. of North Am., No. 20-CV-2037 JLS (NLS), 2022 WL 712926 (S.D. Cal. Mar. 8, 2022) (Judge Janis L. Sammartino).

This week’s case of the week is a significant long-term disability win for plaintiff Maureen Stratton, represented by our talented colleagues at Kantor & Kantor, Corrine Chandler and Andrew Kantor. 

Ms. Stratton, who worked as a senior executive partner at Gartner Inc., began experiencing significant back pain in 2011. This pain progressed to such a point that, by early 2017, she was calling in sick to meetings and could no longer tolerate plane travel or extended sitting. Around that time, she stopped working and applied for disability benefits. Continue Reading Court Credits Treating Physician Over Retained Experts

Wilson v. UnitedHealthcare Ins. Co., No. 20-2044, 2022 WL 552028 (4th Cir. Feb. 24, 2022) (Before Circuit Judges Agee, Thacker, and Quattlebaum).

This week’s notable case once again demonstrates how health insurance claims are confusing and littered with procedural and substantive land mines. This case involves one person who received treatment at one facility during one continuous period of time, yet the Fourth Circuit’s analysis of the related insurance claims submitted for that treatment has resulted in three different holdings: one regarding medical necessity, one regarding the administrator’s breach of fiduciary duty, and one regarding the claimant’s failure to properly follow procedural rules. Continue Reading Fourth Circuit Rules That Administrator’s Failure to Respond to Claimant’s Request for Information Demonstrated Futility of Appealing