New Orleans Federal Judge Remands Surgical Provider’s Lawsuit Against Humana ; Finds ERISA Does Not Preempt State Law Claims

Published by The Pellegrin Firm September 17, 2019

On September 13, 2019, New Orleans federal judge Carl J. Barbier remanded a lawsuit filed by Crescent City Surgical Centre against health insurer Humana to Louisiana state court in Jefferson Parish. Crescent alleges that in 2011 Humana began paying less than what it agreed to pay for services on the Humana provider web portal.

Death on the Job: What Family Members Need to Know About Louisiana Workplace Fatalities

Published by The Pellegrin Firm September 9, 2019

When a loved one dies on the job, it is common to experience grief, resentment, worry, and confusion. Louisiana has thousands of jobs in chemical plants, in the oil and gas industry, in construction, and on vessels. These are very strenuous jobs that pay well. However, they can also be very dangerous.

Analysis: Everything Goes Wrong for Beneficiaries in Western District of Louisiana Life Insurance Case

Published by The Pellegrin Firm September 2, 2019

In an August 20, 2019, ruling out of the U.S. District Court for the Western District of Louisiana, Judge S. Maurice Hicks sided with Metropolitan Life Insurance Company in a dispute against a deceased man’s wife and children over life insurance benefits.

Accidental Death & Dismemberment Policy Payout Denials

Published by The Pellegrin Firm August 23, 2019

Accidental Death & Dismemberment (AD&D) insurance is an important planning tool families use to protect against the consequences of the accidental death of a loved one. In addition, these policies often cover loss of a limb, hearing, or vision due to accident, losses which can seriously affect earning capacity. These policies can be sold by themselves or as a rider to a traditional life insurance policy.

Exhausting Administrative Review in ERISA Cases

Published by The Pellegrin Firm August 20, 2019

In 1974, Congress passed the Employee Retirement Income Security Act (ERISA), which granted claimants a cause of action in federal court for benefits wrongfully-denied pursuant to employer-sponsored retirement plans, disability insurance, life-insurance plans, and other various types of employer-provided benefits.

When May Fiduciary Claims Under ERISA § 502(a)(3) Be Maintained in Disability Benefit Cases?

Published by The Pellegrin Firm August 13, 2019

This question is one of the “labyrinthine complexities” of ERISA law and practice, as stated by the New Orleans-based U.S. Court of Appeals for the Fifth Circuit in last year’s decision, Manuel v. Turner Indus. Grp., L.L.C., 905 F.3d 859 (5th Cir. 2018).

Long-Term Disability: Surveillance, Social Media, and Short Bursts of Activity

Published by The Pellegrin Firm August 11, 2019

Living while receiving long-term disability benefits from an insurance company can feel stifling. If the insurance company is paying tens of thousands of dollars to a claimant yearly, it may find it cost effective to invest in surveillance – either through social media or in person – to find a reason to terminate benefits.

Challenging a Life Insurance Denial

Published by The Pellegrin Firm August 7, 2019

Life insurance disputes are complicated, and beneficiaries will often find that insurance companies will try to find any excuse not to pay what the policy requires. However, life insurance companies must follow strict procedural rules, or they could find themselves having to pay the policy amount plus attorneys’ fees in court. On June 13, 2018, the U.S. Court of Appeals for the Fifth Circuit in New Orleans ruled on the appeal of a woman seeking payment on her husband’s life insurance policy.