Give the burden to us. Regain your peace of mind.
We’ll take it from here. Call now.
Give the burden to us. Regain your peace of mind.
We’ll take it from here. Call now.
As a practical matter, an insurance claimant fighting an ERISA life or accidental death insurance intoxication clause denial on administrative appeal or in court without the help of a seasoned ERISA attorney is ill-advised. But that doesn’t mean you can’t win. It just means you may need help.
The reason an ERISA attorney’s help is advised is that ERISA law is complex, and some of the arguments you need to make to be successful are very technical.
The legal battle in an ERISA case, done right, can also be very tedious and time-consuming. The fight requires a ton of work from the time of the insurance company’s initial denial, through the administrative appeal process, through judgment at the district court level, then finally through judgment at the appeal court level. And the insurance companies typically hire several attorneys who specialize in ERISA law from some of the largest law firms in the country to fight the claimant’s attorney every step of the way.
Our client’s case, summarized above, is a perfect example of the amount of work that can be required to beat an insurance company who argues an intoxication defense. We took a loss on administrative appeal to CIGNA. Then we took another loss at the district court level, meaning the district court judge agreed with CIGNA’s lawyers on the intoxication exclusion defense.
It wasn’t until after taking an appeal to a three-judge panel of the U.S. Fifth Circuit Court of Appeal that my client finally received justice. All told, bringing our client’s case to a successful conclusion took hundreds of hours of work in researching and briefing the facts from an administrative record over 1000 pages long. It took finding the one critical toxicologists report that CIGNA first withheld, buried deep in that record. It took meeting with the Coroner to secure his testimony clarifying his comment made on the death certificate. It took researching and arguing the law to four judges in two separate court proceedings. And at the formal Fifth Circuit court hearing (called “oral argument”), where the attorneys make their arguments in open court to the judges, who pepper them with questions, comments and arguments about their positions, it was hard to tell whose position the judges actually favored. It was certainly nerve-racking for our client, who watched it. It wasn’t until the Court’s formal opinion landed in our email inbox a couple of months later that we could tell our client the good news.
Most claimants have no real way to know what goes into researching, briefing and arguing an ERISA life or accidental death insurance intoxication exclusion case to the court.
So to give claimants some real-world perspective, we’ve reproduced in full our opening brief and reply brief filed in our client’s case with the U. S. Fifth Circuit Court of Appeals below.
If interested, you can also listen to the oral argument by clicking this link.
You can Google White v. Life Insurance Company of North America (CIGNA), 892 F.3d 762, 5th Cir.(La.), June 13, 2018, as revised (Jun 14, 2018) to read the full court opinion.
The Fifth Circuit’s judgment was a just ending for our deserving client, no doubt, but CIGNA should have simply paid the benefits it owed her without withholding critical evidence and putting her through a ridiculous fight. It would have saved court resources, attorney’s fees on both sides and much delay and distress for a grieving widow.
Unfortunately, unfair ERISA insurance claim denials won’t end anytime soon.
The most powerful tool we have at our disposal to help curb abuse is public awareness.
My client’s hope is that her story will be shared, ultimately spread to insurers across the country and hopefully curb rampant insurance company abuse.
And she also hopes that her experience will be shared with others to empower people who are victims of that abuse to keep fighting and never give up their hope for justice.
So please share her story with others.
Please also share with us any unfair insurance claim denial stories you know or have experienced.
This has been a very difficult time for myself and my family. Mr. Mcnamara did his best to be as empathetic and compassionate as possible. He is very knowledgeable and a man of great integrity.
This has been a very difficult time for me and my family, but Mr.Mcnamara has been very empathetic and understanding. He is extremely knowledgeable and a man of great integrity. I truly appreciate everything he did to make this as Tolerable as possible.
I am so thankful Price was my attorney during this difficult time in my life after losing my fiance. He made me feel very comfortable I trusted that he had my best interests in mind. I highly recommend him I was truly blessed to have had him help me fight for what is mine.
I would like to take a moment to thank Mr. Price McNamara for the leadership of legal counsel aid him and his staff showed through the entire process of working with me with my Disability case. I will highly recommend Mr. Price McNamara to anyone that needs someone that is outstanding to fight for their
Price was instrumental in assisting me through the disability process. Without his help and guidance, I do not think that I would have been successful !!!!
Price was instrumental in assisting me through the disability process. Without his help and guidance , I do not think that I would have been successful !!!! Thank you Price.
Price was instrumental in assisting me through the disability process. Without his help and guidance , I do not think that I would have been successful !!!! Thank you Price.
Mr Price is great attorney with great skills and lot of experience. But BEST QUALITY he has that he is wonderful human being he care for your family and you as a human being. My family thanks you very much. GOD bless you and your staff.
The law firm of Price McNamara has successfully settled our law suit when other attorneys said that we had no case Price assured us that we did and in eight months he was able to negotiate a settlement that we were told that we could not get. I highly recommend his law firm and I
I want to say thanks to J. Price McNamara for the sound free advice he gave me related how to increase my chances of being approved for Long Term Disability of being denied. I must say after implementing elements of his sound advice such as showing the insurance company proof of how my illness/disability had
I needed an attorney with a specific specialty and Price McNamara was definitely the right choice. His representation was based on principles that are probably unsurpassed by any other attorney in the field. McNamara represents individuals, not big-money corporations, like so many others in his field of specialty. He is a consummate professional, extremely knowledgeable
I found Mr. McNamara to be practical and efficient. He did what I needed in a reasonable amount of time, keeping me well informed and with excellent results. He communicated with me clearly and on a timely basis. I will use him in the future.
I am a current client of Mr. McNamara’s. He is very accessible and responds to my emails and phone calls in a timely manner. I find him to be very professional and knowledgeable, as well as ready, willing and able to address all of my questions and/or concerns.
I am an attorney. Price represented me, and in a separate suit represented my daughter, for injuries. He moved the cases at lightning speed and obtained maximum recovery. I was grateful and surprised. I would recommend Price to anyone who wants a top-notch attorney who gets results.
I would recommend Mr. Mcnanmara to anyone at any time. He was the best attorney that my family and I came in contact with. About three years ago we had a very tragic, accidental death in our family and the company knew that it was their fault but of course tried passing the buck. Mr.
Price and Sara are great. They helped us in a time of need. Their communication was always spot on and I never felt out of the loop with what was going on with our case.
Price is very professional, honest, and reliable. Whatever he says, he will follow through with the utmost integrity. He will turn over every stone and pays close attention to even the smallest detail. I’m glad I secured his services.
Without going into the painful details regarding the reason for having to hire Price, his compassion and communication helped my family during an extremely difficult time. If you need legal help because you or a family member was injured by something or someone else, don’t hesitate to call him.
Client Linda Shares Her Experience
Client Oscar Shares His Experience
Client Lauren Shares Her Experience
Client Testimonials
Complete the confidential form below for a free, no obligation case evaluation and we’ll tell you how we can help.
You may also call us at the number below. J. Price McNamara and his legal support team are focused on building a strong case for you.
Copyright 2020. All Rights Reserved
How did we do?
Note: Your review may be shared publicly.
