Since the publication in 1943 of James M. Cain’s noir classic, “Double Indemnity,” there has been a public fascination with accidental death insurance. Surprisingly, even when a sudden and unexpected death occurs other than as a result of a heart attack or other clear-cut medical condition, the issue of whether the death was accidental or […]
Causation is always a key issue in accidental death insurance claims as a recent 1st U.S. Circuit Court of Appeals decision teaches.
In Arruda v. Zurich American Insurance Co., 2020 WL 880548 (1st Cir., Feb. 24), the 1st Circuit overturned a judgment in favor of the plaintiff, Denise Arruda, in relation to an accidental death insurance claim relating to the death of her husband, Joseph Arruda. The insurer maintained that Joseph’s death was caused or contributed to by Joseph’s pre-existing health conditions. The 1st Circuit agreed.
Litigating health benefit claim denials is extremely challenging for plaintiffs. Especially under the Employee Retirement Income Security Act — where many cases are decided under the arbitrary and capricious standard of review that upholds an insurance claim denial so long as the basis for the claim decision is viewed as reasonable by a court
Mark D. DeBofsky is a name partner of DeBofsky Law He handles civil and appellate litigation involving employee benefits, disability insurance and other insurance claims and coverage, and Social Security law. A recent decision issued by the 7th U.S. Circuit Court of Appeals offers valuable insight into the meaning of the de novo standard of […]
Mark DeBofsky has been invited to speak at the American Association for Justice (AAJ) Annual Convention taking place July 11-14, 2020, in Washington, D.C. DeBofsky will be speaking on developments in life, health, and disability insurance. Visit www.justiceannualconvention.org for more information.