Life, Health and Disability

For over a half a century, the representation of first party insurers has been an important part of Armstrong Teasdale’s practice. Insurers are among the firm’s oldest clients because their business and needs are understood. The life, health and disability lawyers represent four out of five of the top life insurance companies operating in Missouri, based on market share data statistics from the Missouri Department of Insurance. The group is proud to represent a significant number of A.M. Best’s top 50 Life/Health Companies in Missouri, Kansas, and Illinois.

ERISA

Issuance of life, health and disability policies is the primary business of top insurers. Therefore, knowledge of ERISA and the related regulations and cases has been a key component of the life, health and disability practice for over two decades. Given the high cost of litigation and the risk of having the plaintiff’s legal fees assessed against clients, the group’s philosophy is simple: provide an early, realistic assessment so that clients can make an informed choice about whether to fight. Essential to this process is the knowledge of ERISA preemption issues, the substantive law of ERISA, the standard of review the court will apply, and whether additional evidence will be considered. Equally important is the experience to know what facts will persuade the court, and how to present them. The life, health and disability lawyers' success on motions for summary judgment is indicative of the group’s ability to separate the wheat from the chaff in this critical field. * 

Non-ERISA

While ERISA-based litigation has become a major staple of the Life, Health and Disability Practice Group, the members have not forgotten their roots and continue an excellent tradition of representation in the area of individual and group non-ERISA cases, including governmental and church plans.

Administrative Proceedings

In addition to representation in private litigation, the life, health and disability lawyers assist clients in dealing with the Missouri Department of Insurance. One member is a former lawyer with the Missouri Department of Insurance and offers unique insight into regulatory complaint and compliance issues. 

Practice Highlights

• Dismissal of the insurer on an accidental death policy where insured's death resulted from overdose of medication taken as prescribed. Grobe v. Vantage Credit Union, et al., F.Supp.2d, 2010 WL 198462 (E.D. Mo. 2010)
• Summary judgment for insurer on life insurance policy where insured failed to disclose five-day hospitalization on application. West v. Wilton Reassurance Life Company of New York, 601 F.Supp.2d 1133 (W.D. Mo. 2009)
• Summary judgment for the plan on the grounds that the plan insurer, Life Insurance Company of North America, did not abuse its discretion in finding that the claimant was not disabled from any occupation. The Court held: "The FCE's objective conclusions of plaintiff's work ability and the lack of objective evidence for any contrary conclusion supports LINA's determination that plaintiff did not meet the Plan definition of disabled." Maxfield v. State Farm Mutual Automobile Insurance Company, U.S. District Court, District of Kansas, Cause No. 05-1164  (September 12, 2006) http://www.armstrongteasdale.com/PracticeAreas/InsuranceCoverage-Litigation/2006-09-12%20memorandum.pdf   
• Summary judgment for the plan on the grounds that its decision that claimant was not disabled from any occupation was not an abuse of discretion and claimant had failed to show grounds for a heightened standard of review. Crawford v. UNUM Life Insurance Company of America, U.S. District Court, Western District of Missouri, Cause No. 03-0732 (May 17, 2005)
• Summary judgment for the insurer on the grounds that the record failed to show a valid change of beneficiary or increase in coverage, and claimant did not demonstrate good cause for failure to submit such evidence at the administrative level. Whittington v. Metropolitan Life Insurance Company, U.S. District Court, Eastern District of Missouri, Cause No. 4:03CV1642 (April 14, 2005)
• Summary judgment for the insurer on an accidental death policy on the grounds that the insurer did not abuse its discretion in finding that the decedent had cancelled his coverage prior to his death and that, in any event, the death was a suicide which was excluded from coverage. Evidence outside of the administrative record was rejected. Quick v. Daimler/Chrysler Corp., et al., U.S. District Court, Eastern District of Missouri, Cause No. 4:03CV01614 (April 4, 2005)
• Complete dismissal of a putative national class action against a credit life insurer client. The dismissal was granted in normally pro-plaintiff St. Clair County, Illinois, where, along with Madison County, a number of similar putative class actions, and some that have been certified, are presently pending. In a case of apparent first impression in Illinois, and on an issue as to which courts nationally appear to be split, the trial judge agreed with us and dismissed plaintiff's lawsuit in its entirety on statute of limitations grounds. Welmon v. Globe Life Ins. Co., No. 03-L-0038 (St. Clair County, Ill., Dec. 18, 2003) http://www.armstrongteasdale.com/PracticeAreas/InsuranceCoverage-Litigation/DismissalOfClassActionAgainstCreditLifeInsurer.php    
• Summary judgment for the insurer on grounds that a parachute was a device for aerial navigation. Adams v. Continental Casualty Company, U.S. District Court, Western District of Missouri, Cause No. 01-208-CV-DW (April 16, 2003)   
• Summary judgment for the insurer on an eligibility issue under a group accidental death policy. Shields v. Continental Casualty Company, 209 F.Supp.2d 1176 (D. Kan. 2002)
• Summary judgment for the insurer on the grounds that the insurer was prejudiced by the participant’s untimely filing of a claim for benefits affirmed by the Eighth Circuit. Goble v. Continental Casualty Company, 2001 WL 315631 (8th Cir. 2001)
• Summary judgment for insurer on grounds that the accounting sought by plaintiff was not the appropriate cause of action affirmed by the Missouri Court of Appeals. Cento v. John Hancock Mut. Life Ins. Co. , 59 S.W.3d 556 (Mo.App. E.D. 2001)
• The trial court denied certification of a putative nationwide class, which was not appealed, and then the appellate court ruled in favor of the insurer on a policy construction issue that could have eliminated the benefits cap on individual major medical policies. Leventhal v. Trustmark Ins. Co., 39 S.W.3d 46 (Mo. App. 2001)

Representative Matters

Accidental death  Agency and agent licensure matters Credit life claims Disability claims  Experimental treatment disputes  Form A hearings  Fraudulent insurance applications

Fraudulent misrepresentations by agents Interpleader Actions  Life claims Market conduct examination disputes Negligent failure to issue    Policy approval applications

Members of the Life, Health and Disability Practice Group

Calvert, Winston	Ochs, Megan
Clinkinbeard, Karrie	Sakaguchi, Daniel
Cole, Clark	Shorey, Matthew
Doctorian, Sherry	Stockberger, Jim
Greene, Dione	Summerville, Jay
Jones, Corbyn	Tomlinson, Wil
Kenny, Patrick	Turner, Matt
King, Jerry	Weaver, Tom
Melly, Sara	Wendler Modde, Deanna
Moore, Katie

*Past results afford no guarantee of future results and every case is different and must be judged on its own merits.