Claims brought against life, health and disability insurers often involve unique and complex issues. Wilson Elser maintains a national practice team, highly specialized and experienced in handling these claims. We represent insurers in all types of litigation, including first party bad faith claims, agent misconduct and compensation disputes, trademark infringement, 419 welfare benefit plans, 412i defined benefit plans, and employment issues.
Wilson Elser has a significant and growing experience with cases involving stranger-originated life insurance (STOLI). Our attorneys have written and presented extensively regarding STOLI and we are actively involved on a day-to-day basis helping our clients to stay abreast of and shape the development of the law to address this modern phenomenon.
Our primary focus is representing our insurance clients at the trial level. We also represent insurers in administrative actions, before the NASD, and at the appellate level. We routinely advise our clients on pre-litigation issues, and we provide training to our clients on current legal developments and Insurance Department compliance.
We also have extensive experience in insurance issues arising from the Employee Retirement Income Security Act of 1974 (ERISA). Claims brought under ERISA are on the rise, and complex ERISA law is ever-changing. Defendants in such claims must be prepared to address issues such as ERISA preemption, breach of fiduciary duty, fraud and misrepresentation, the burden of reporting and disclosure, and potential financial exposure.
Our team of experienced attorneys represents plans, employers, insurers, fiduciaries, and third-party administrators in claims brought under ERISA. Among the matters we have dealt with are claims seeking benefits and claims for breach of fiduciary duty. These matters have included issues involving the "employee" requirement for ERISA coverage, medical necessity, disability benefits, pre-existing condition limitations, notice of claim denial and plan rights, exhaustion of administrative remedies, exclusionary language in ERISA plans, as well as claims for restitution, rights of reimbursement, and statutory penalties.
Our attorneys have prosecuted claims on behalf of ERISA fiduciaries seeking restitution for benefits mistakenly paid and for reimbursement from tort recoveries. We also have tried cases involving claims for denial of severance benefits, wrongful termination of disability benefits, wrongful discharge under ERISA, eligibility for ERISA medical benefits, and medical provider insurance fraud.
Attorneys in the firm's life, health, disability and ERISA practice team are frequent speakers at industry seminars, have authored numerous articles in trade publications concerning case law developments, and regularly consult with clients on compliance and other matters affecting life, heath and disability insurers.