Conclusion In this case, the plaintiff’s disability
benefits were terminated by her insurance carrier in May, 2008. She timely pursued the internal appeal required by the plan and promptly instituted litigation when her appeal was unsuccessful. Her case was litigated aggressively, with few continu- ances. Despite the diligent prosecution of her claim, the appeal and the claim litiga- tion, she did not receive her benefits until April, 2011 – almost three years later. This is not an unusual case. ERISA cases are subject to the same
court calendars that govern civil litigation. However, ERISA claimants must first exhaust the administrative appeal process prior to filing suit, which can add six months to a year to the claim process. Needless to say, the judicially inferred
stated goal of a “speedy and expedient” claim process was not accomplished in this case. There were over 100 docket entries, plus an ancillary action in New York City. While the carrier may complain that the discovery disputes unnecessarily prolonged the case, plaintiff believes that the motion proceedings were necessary and useful in view of the carrier’s refusal to produce portions of the claim file and its own internal claim procedures upon request.
Judge Acker’s criticism of the Act and
the failure of the Congressional purposes are, sadly, directly on point. The goal of an expedient resolution process has not been accomplished by judicial rules, tying the hands of the judiciary and claimants in presenting evidence in support of a claim. Nor have the judicial rules served the other goal of ERISA – the protection of an employee’s right to their benefits. Instead, the judicially-created rules have resulted in a process that permits carriers to protect their claims process from pub- lic scrutiny. This is a far cry from legisla- tion which was intended to protect employees’ right to recover benefits to which they are entitled.
Corinne Chandler is a Senior Attorney
with Kantor & Kantor, LLP, a firm which specializes in representing insureds in actions to recover life, health and disability benefits.
Ms. Chandler has over 25 years of experience litigating life, disability and long- term insurance benefit disputes, and has liti- gated close to 1,000 such disputes. She received
a B.A. Degree from St. Mary’s College, Notre Dame, Indiana, and her J.D. Degree from De Paul University, College of Law. She is admit- ted to practice law in Illinois and California.
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11620 Wilshire Blvd., Suite 100, Los Angeles, CA 90025 JUNE 2011 The Advocate Magazine — 61
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