Some of our recent published decisions:

  • Salyers v. Metropolitan Life Insurance Co., 871 F.3d 934 (2017)--MetLife waived its right to request an evidence of insurability form by accepting premiums and failing to provide the form to the plan participant in this ERISA case.  MetLife also was deemed to be the principal of the employer, and all of the employer's knowledge and actions were imputed to Met Life.
  • Carrier v. Aetna Life Insurance Co., 116 F.Supp.3d 1067 (2015)--Aetna's denial of disability benefits was improper when it was purportedly based on the opinion of a psychiatrist when in fact no psychiatrist review the file prior to the denial.
  • Ventura Kester, LLC v. Folksamerica Reinsurance Co., 219 Cal. App. 4th 633 (2013)--Court of Appeal found that the owner of a commercial building that had suffered a vandalism loss while the building was vacant had coverage for loss of rents even though the building was not leased to a tenant.
  • Barrowes v. Aetna Health, 472 Fed. Appx. 449 (9th Cir. 2012)--Ninth Circuit finds that out-of-network brain surgery was an emergency and therefore fully covered under HMO health plan.
  • Evans v. Mutual of Omaha Insurance Co., 134 Fed. Appx. 194 (9th Cir. 2005)--Agent for group plan is proper defendant and defeats diversity jurisdiction, requiring remand back to state court.
  • E.M.M.I. Inc. v. Zurich American Insurance Co., 32 Cal. 4th 465 (2004)--California Supreme Court ruled that jeweler's block policy covered loss when driver was outside of the vehicle as he was still "in or upon" the vehicle.