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380 South Melrose Drive, Suite 333, Vista, California 92081
16870 West Bernardo Drive, Suite 400, San Diego, California 92127
Telephone: (760) 565-2027 or (858) 333-7133 - Email: hbhellen@gmail.com

 



Long-Term Disability & Health Insurance Claims

We specialize in appeals of denials of long-term disability benefits as well as medical insurance claims (including COBRA). This is done for both group benefits, usually covered under the federal Employment Retirement Income Security Act ("ERISA"), as well as for individual benefits purchased directly by the client.

ERISA claims need specialized handling. The ERISA law is very complex and changes constantly with new Circuit Court and Supreme Court decisions coming down all the time. Remedies available under other laws are not available to claimants under ERISA (such as damages for emotional distress and punitive damages) and jury trial is unavailable. Very few attorneys have the knowledge, experience, and track record to properly handle such cases. This firm has handled numerous ERISA claims at all levels, from pre-denial consultations to internal (administrative) appeals of claims denials, through federal court litigation and United States Circuit Court appeals. To see how complex and challenging an ERISA case is, please click on this link: Anatomy of an ERISA Claim.

Bad faith claims are those where an individual has purchased disability or health insurance and the claim is wrongfully denied. These claims can be handled either in State or Federal Court. These also apply to some group claims not covered under ERISA, in particular for employees of government entities at any level. Here the usual remedies are all available, and the right t a jury trial exists.

The firm has substantial experience representing clients with a large variety of disabling illnesses or injuries, including the following:

  • Fibromyalgia Syndrome (FMS)
  • Chronic Fatigue Syndrome (CFS)
  • Chronic Fatigue Immune Dysfunction Syndrome (CFIDS)
  • Spinal injury (including nerve damage)
  • Severe carpal tunnel syndrome
  • Multiple Chemical Sensitivity (MCS)
  • Myofascial Pain Syndrome (MPS)
  • HIV/AIDS
  • Eye/vision damage/illnesses
  • Brain aneurysms
  • Multiple Sclerosis
  • Rheumatoid Arthritis

We have obtained successful results for our clients from the following insurance companies and Fortune 500 Companies:

  • UNUM/Provident/Paul Revere
  • Standard
  • Prudential
  • Hartford
  • CNA
  • Great-West
  • Canada Life
  • Unicare
  • Fortis
  • Hewlett-Packard Company
  • Sempra Energy (San Diego Gas & Electric)
  • Reliance Standard
  • Jefferson Pilot
  • Equitable Life/AMAX
  • Aetna
  • CIGNA

PUBLISHED AND REPORTED DECISIONS:

Lang v. Long-Term Disability Plan of Sponsor Applied Remote Technologies (Standard Insurance Co.) 125 F.3d 794 (9th Cir. 1997)

Walker v. UNUM Life Insurance Co. of America, 83 Fed.Appx. 902; 2003 US App. LEXIS 25271 (9th Cir. 2003)

Frost v. Intel Corp., 37 Fed.Appx. 295; 2002 US App. LEXIS 11706 (9th Cir. 2002)

Benson v. Xerox Corp., 242 F.3d 380 (9th Cir. 2000)

Capianco v. Long-Term Disability Plan of Sponsor Uromed Corporation (Harford Life & Accident Ins. Co.), 247 Fed .Appx. 885; 2007 US App. LEXIS 20286 (9th Cir. 2007)

Patrick v. Hewlett-Packard Company, 638 F.Supp.2d 1195 (US Dist. Court, SD Cal., 2009)

 


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