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

Lauren E. Sparks

Lauren E. Sparks

Joan O. Vorster

Joan O. Vorster

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 

Our Practices