Robinson+Cole has successfully defended disability, life, and accident claims brought in state or federal court against insurers, plan administrators, employers, and managed care organizations, including cases governed by the Employee Retirement Income Security Act (ERISA), the Federal Employees Health Benefits Act (FEHBA), Medicare, Medicaid, and the Federal Employees' Group Life Insurance (FEGLI) program. We also provide guidance, advice, and assistance to our clients regarding policies and procedures for managing life, health and disability claims.
The learning curve for this type of claim work can be steep. State insurance departments and federal regulators frequently change the rules and procedures governing coverage and claim evaluation, and it is necessary to know what has changed and why. Appellate courts, including the United States Supreme Court, regularly change the rules governing claim litigation. The language of insurance policies and benefit plans can sometimes be complex, requiring an experienced eye to comprehend them, and it is often necessary to master a wide range of medical issues to fully understand, evaluate, and defend a claim. Our Managed Care lawyers can maneuver the complexities of this environment. They know the framework inside and out and have worked on “building the law” in terms of life, health, and disability claims.
Our Services
Our lawyers have deep-seated experience in all areas of life, health, and disability litigation, including the following:
Disability Claim Litigation
- Trials of individual claims
- Appeals
- Wrongful denial/termination of LTD benefits
- Interference with employee benefit rights
- ERISA preemption
- Recoupment of overpaid benefits/subrogation
- Breach of fiduciary duty
- Bad faith
- Deceptive/unfair business practices
Life + Accident Claim Litigation
- Interpleader of life insurance benefits where there are conflicting claims for benefits
- Disputes over whether insured’s death was “accidental” or caused by self-inflicted injury
- Drug or alcohol intoxication
- Retained asset account litigation and disputes
Our wide spectrum of clients includes insurance companies and life, health, disability, and accidental death and dismemberment (AD&D) benefit claim administrators. We have represented claim administrators and plan sponsors in individual and class actions alleging breaches of ERISA fiduciary duty, violations of mental health parity laws, improper offsets against benefits for Social Security disability income benefits, and third-party tort settlements.



