Life, Health, Disability and ERISA Litigation

The firm’s Life, Health, Disability and ERISA Litigation Group has a long history of providing our clients with consistently successful results on their behalf whether it be through negotiation, mediation, summary judgment, arbitration, trial or appeal. We exclusively represent insurers, employee benefit plans, and third-party administrators. Our clients include some of the largest life and disability insurance companies in the United States.

We handle cases in connection with both individual and group claims, under state and federal law. Members of our team regularly lecture and write scholarly articles. Our expertise covers a full array of issues arising in this area of litigation including the defense of life, health and disability benefit claims, long-term care, rescission and reformation cases, interpleader, breach of fiduciary duty allegations, and bad faith claims, including the Massachusetts consumer protection statute, Chapter 93A. The team also handles matters concerning government investigations or inquiries initiated by state administrative agencies including the Department of Insurance and the Massachusetts Attorney General. Many clients seek our advice before a claim reaches a formal dispute to help evaluate complex factual or legal issues. We also provide training to clients to help manage legal risks in the life, health and disability arena.

While based in Massachusetts, our representation is regional in nature encompassing Connecticut, New Hampshire and Rhode Island. We have also been specially admitted in other jurisdictions. We have successfully represented dozens of insurers, employee benefit plans and third-party administrators in literally hundreds of cases through the full range of trial and appellate courts, including the Massachusetts Appeals Court, the Supreme Judicial Court and the First Circuit Court of Appeals. Our attorneys have resolved numerous cases through negotiation and mediation. However, when necessary, we have litigated cases to a final conclusion obtaining numerous favorable rulings and verdicts by defending against preliminary injunctions or litigating motions for summary judgment, arbitrations and trials. We have also represented our clients in precedent-setting decisions before the First Circuit Court of Appeals and the Massachusetts Supreme Judicial Court and Appeals Court. While represented by our group, no client has had a bad faith claim successfully prosecuted against it.
 

Practice Chairs

Kevin  Kam

Kevin Kam
Associate

Lauren E. Sparks

Lauren E. Sparks
Associate

Joan O. Vorster

Joan O. Vorster
Partner

Jillian I. May

Jillian I. May
Paralegal

Life, Health & Disability e-Report First Circuit, Fall 2017

09/12/2017[ read full story ]

First Circuit Opens Door to Right to Jury Trial in MA Consumer Protection Actions

08/24/2017[ read full story ]

Montanile: Now What?

02/16/2016[ read full story ]

Insurance Agent is Independent Contractor, Not Employee

12/17/2015[ read full story ]

Representative Matters

  • Successfully represented insurer before the Massachusetts Appeals Court which upheld a judgment that an insurance policy was properly rescinded for fraudulent misrepresentations
  • Obtained a judgment in the Massachusetts Superior Court in 2011 that an insured had failed to comply with the appropriate care provision of his disability policy by failing to undertake mental health treatment recommended as a consequence of an independent medical examination
  • Obtained a ruling in federal district court requiring that the ERISA plan participant show the denial of benefits was improperly influenced by a conflict of interest before discovery was permitted  
  • Obtained a jury verdict in 2008 in Massachusetts state court for an insurer against an insured claiming that total disability was a result of an accident, rather than a sickness
  • Obtained an arbitration award in 2008 voiding a life insurance policy for a change in an insured’s health between the date of the application and the date of the issuance of the policy   
  • Represented an insurer in obtaining a precedent-setting ruling in federal district court regarding the production of surveillance materials in discovery   
  • Obtained a ruling on behalf of an insurer in federal district court that an administrative record could not be opened to admit evidence generated after a final decision on an ERISA claim  
  • Represented an insurer in federal district court in establishing grounds for a rescission of coverage in a benefit plan governed by ERISA   
  • Obtained a summary judgment decision that attention deficit disorder was a mental illness as defined by the ERISA plan   
  • Represented an insurer before the U.S. Court of Appeals for the First Circuit in establishing that summary judgment is the appropriate means to resolve an ERISA case regardless of the standard of review and that enlargement of the administrative record is not permitted after the administrative appeal is decided   
  • Represented an insurer before the U.S. Court of Appeals for the First Circuit in establishing that an individual disability policy was encompassed within an ERISA plan   
  • Represented a disability insurer before the U.S. Court of Appeals for the First Circuit in establishing the standard of review in an ERISA benefit claim determination 

Circuit Courts of Appeals

  • Schad v. Sun Life Assurance Co. of Canada, 358 Fed. Appx. 242 (2nd Cir. 2009)
  • Sun Life Assurance Company of Canada v. Sampson, 556 F.3d 6 (1st Cir. 2009)
  • Orndorf v. Paul Revere Life Ins. Co., 404 F.3d 510 (1st Cir. 2005)
  • Paul Revere Life Ins. Co. v. Bromberg, 382 F.3d 33 (1st Cir. 2004)
  • Bekiroglu v. Paul Revere Life Ins. Co., 75 Fed. Appx. 8 (1st Cir. 2003)
  • Brigham v. Sun Life of Canada, 317 F.3d 72 (1st Cir. 2003)
  • Nickerson-Malpher v. Market Forge Group Life Insurance Plan, 26 Fed. Appx. 11 (1st Cir. 2001)
  • Tompkins v. United HealthCare of New England, 203 F.3d 90 (1st Cir. 2000)
  • Doe v. Travelers Ins. Co., 167 F.3d 53 (1st Cir. 1999)
  • New England Mut. Life Ins. Co. v. Baig, 166 F.3d 1 (1st Cir. 1999)
  • Doyle v. Paul Revere Life Ins. Co., 144 F.3d 181 (1st Cir. 1998)
  • Golas v. Homeview, Inc., 106 F.3d 1 (1st Cir. 1997)
  • Belanger v. Wyman-Gordon Co., 71 F.3d 451 (1st Cir. 1995)

State Appellate Courts

  • Yunes v. Unum Group, 88 Mass. App. Ct. 1117; 2015 WL 8286021 (2015)

  • Korn v. The Paul Revere Life Insurance Company, 83 Mass. App. Ct. 432 (2013)

  • Metropolitan Life Insurance Company v. Cotter, 464 Mass. 623 (2013)

  • Gray v. Fidelity and Guaranty Life Ins. Co., 79 Mass. App. Ct. 1123; 2011 WL 2183854 (2011)


Federal District Courts

  • Kamerer v. Unum Life Insurance Company of America, 251 F.Supp.3d 349 (D. Mass. 2017); 334 F.Supp.3d 411 (D. Mass. 2018)
  • Libby v. Unum Life Insurance Company of America, 2018 WL 1662183 (D. Mass. 2018)
  • Ovist v. Unum Life Insurance Company of America, 2018 WL 3853739 (D. Mass. 2018)
  • Prokhorova v. Unum Life Insurance Company of America, 2018 WL 1913801 (D. Mass. 2018)

  • Rosenthal v. Unum Group, 2018 WL 1250483 (D. Mass. 2018)

  • Schwartz v. Keolis Commuter Services, 2018 WL 1411202 (D. Mass. 2018)

  • Hack v. AXA Equitable Life Ins. Co., 2016 WL 5662016 (D. Mass. 2016)

  • Kurma v. Starmark, Inc., 160 F.Supp.3d 420 (D. Mass. 2016)

  • Sugalski v. The Paul Revere Life Insurance Company, 2015 WL 1443117 (D. Mass. 2015)

  • Doe v. Unum Life Ins. Co. of America, 35 F.Supp.2d 182 (D. Mass. 2014)

  • Prouty v. Hartford Life and Acc. Ins. Co., 997 F.Supp.2d 85 (D. Mass. 2014)

  • Ginsberg v. Provident Life and Accident Insurance Company, 2013 WL 6008937 (D. Mass. 2013)

  • Humphrey v. Paul Revere Life Ins. Co., 2012 WL 928532 (D. Mass. 2012)

  • Drake v. Town of Mansfield v. Sun Life Assurance Co. of Canada, 652 F.Supp.2d 236 (D. Conn. 2009) 

  • Forrest v. The Paul Revere Life Insurance Company, 662 F.Supp.2d 183 (D. Mass. 2009)

  • McGahey v. Harvard University Flexible Benefits Plan, 685 F.Supp.2d 168 (D. Mass. 2009)

  • Shaffer v. Foster-Miller, Inc., 650 F.Supp.2d 124 (D. Mass 2009)

  • Donovan v. AXA Equitable Life Insurance Company, 252 F.R.D. 82 (D. Mass. 2008)

  • Paul Revere Life Ins. Co. v. Bromberg, 2008 U.S. Dist. LEXIS 50806 (D. Mass. 2008); adopted and judgment entered in Paul Revere Life Ins. Co. v. Bromberg, 2008 U.S. Dist. LEXIS 50801 (D. Mass. 2008)

  • Simokonis v. Saint-Gobain Corp., 2007 WL 2259104 (D. Mass. 2007); 2008 WL 660377 (D. Mass. 2008) 

  • Reeder v. Sun Life Assurance Company of Canada, Inc., 497 F.Supp.2d 125 (D. Mass. 2007)

  • Thiffault v. Sun Life Assurance Company of Canada, 2007 WL 465182 (D. Mass. 2007)
  • O’Leary v. Provident Life & Accident Insurance Company, 456 F.Supp.2d 285 (D. Mass. 2006)
  • Sun Life Assurance Co. of Canada v. Conroy, 431 F.Supp.2d 220 (D. R.I. 2006)

  • DePardo v. MFS/Sun Life Financial Distributors, Inc., 2005 WL 1225977 (D. Mass 2005)

  • Leitzes v. Provident Life & Accident Ins. Co., 379 F.Supp.2d 15 (D. Mass. 2005)

  • Landman v. Paul Revere Life Ins. Co., 337 F.Supp.2d 283 (D. Mass. 2004)

  • Andrews-Clarke v. Lucent Technologies, Inc., 157 F.Supp.2d 93 (D. Mass 2001)

  • Tuohig v. Principal Ins. Group, 134 F.Supp.2d 148 (D. Mass. 2001)
  • Paul Revere Variable Annuity Ins. Co. v. Thomas, 66 F.Supp. 2d 217 (D. Mass. 1999)

  • Vickers v. Principal Mut. Life Ins. Co., 993 F.Supp. 19 (D. Mass. 1998)
  • Andrews-Clarke v. Travelers Ins. Co., 984 F.Supp. 49 (D. Mass. 1997)
  • Finne v. Paul Revere Life Ins. Co., 981 F.Supp. 57 (D. Mass 1997)

  • Sotiropoulos v. Travelers Indem. Co. of Rhode Island, 971 F.Supp. 52 (D. Mass 1997)

  • Whalen v. Wyman-Gordon Co., 976 F.Supp. 95 (D. Mass. 1997)
  • Garganigo v. Wyman-Gordon Co., 1994 WL 326621 (D. Mass. 1994)
  • Kiley v. Travelers Indem. Co. of Rhode Island, 853 F.Supp. 6 (D. Mass. 1994)

State Trial Courts

  • Jewel v. Unum Provident Corporation, 2005 WL 705050 (Mass. 2005)
  • Fallon v. Federal Express Corp., Inc., 2002 WL 31677216 (Mass. 2002)
  • Paul Revere Life Ins. Co. v. Payne, 2000 WL 424499 (Mass. 2000)
 

Our Practices