UNUM Life Ins. Co. of America v. Ward, 526 U.S. 358 (1999)

UNUM Life Ins. Co. of America v. Ward, 526 U.S. 358 (1999).

US Supreme Court Appeals AttorneySummary

Mr. Ehrlich briefed and argued this case in the U.S. Supreme Court. In a unanimous decision the Supreme Court adopted the position advocated by Mr. Ehrlich, and limited ERISA’s preemptive scope by making ERISA plans subject to state common-law rules of insurance regulation, which generally benefit consumers. The Ward decision benefited more than 80 million people who obtained their health insurance, life insurance, or disability insurance through their employer.

Download Decision (.pdf)


Facts of the Case

UNUM Life Insurance Company of America (UNUM) issued a long-term group disability policy to Management Analysis Company (MAC) as an insured welfare benefit plan governed the Employee Retirement Income Security Act of 1974 (ERISA). The policy provides that proof of claims must be furnished to UNUM within one year and 180 days after the onset of disability. John E. Ward, a California MAC employee, became permanently disabled in May 1992. Ward informed MAC of his disability in late February or early March 1993. UNUM received proof of Ward’s claim on April 11, 1994. Ward was notified that his claim was denied as untimely because his notice was late under the terms of the policy. Ward then filed suit under ERISA’s civil enforcement provision to recover the disability benefits provided by the plan. Ward argued that, under California’s common-law agency rule, an employer administering an insured group health plan should be deemed to act as the insurance company’s agent; therefore, his notice of permanent disability to MAC, in late February or early March 1993, sufficed to supply timely notice to UNUM. The District Court rejected Ward’s argument and ruled in favor of UNUM, citing ERISA’s preemption clause, which states that ERISA provisions “shall supersede … State laws” to the extent that those laws “relate to any employee benefit plan.” In reversing, the Court of Appeals noted that Ward might prevail under California’s “notice-prejudice” rule, under which an insurer cannot avoid liability although the proof of claim is untimely, unless the insurer shows it suffered actual prejudice from the delay.

Question

Does the Employee Retirement Income Security Act of 1974 preempt California’s common-law agency rule, under which a California employer administering an insured group health plan should be deemed to act as the insurance company’s agent? Does ERISA preempt California’s “notice-prejudice” rule?

Conclusion

Yes and no. In a unanimous opinion, delivered by Justice Ruth Bader Ginsburg, the Court held that California’s agency rule is preempted by the Employee Retirement Income Security Act of 1974. Justice Ginsburg wrote for the Court that California’s common-law agency rule “would have a marked effect on plan administration,” adding that it would force employers to take on a role for which they had not volunteered. Further, the Court held that California’s notice-prejudice rule is not preempted by ERISA because it is a “law … which regulates insurance.” Thus, Ward’s insurance claim may go forward even though he filed for benefits after the deadline because UNUM did not suffer any prejudice from the delay. “By allowing a longer period to file than the minimum filing terms mandated by federal law, the [California] rule complements rather than contradicts ERISA and the regulations,” wrote Justice Ginsburg.

Decisions

Decision: 9 votes for Ward, 0 vote(s) against
Legal provision: Employee Retirement Income Security



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Southern California appeals attorney, Jeffrey Isaac Ehrlich, is an appellate specialist certified by the State Bar of California’s Committee on Legal Specialization. He is the principal of the Ehrlich Law Firm, in Encino, Los Angeles County, California.

Ehrlich Law Firm wins a published opinion allowing punitive-damage claim to proceed against Kaiser health plan

San Bernardino Certified Appellate Specialist

Ehrlich Law Firm wins a published opinion allowing punitive-damage claim to proceed against Kaiser health plan

California Courts of Appeal SealOn February 15, 2012, the California Court of Appeal issued its opinion in Kaiser Foundation Health Plan, Inc. v. Superior Court (Rahm)(2012) __ Cal.App.4th __.  The opinion holds that a health-care service plan like Kaiser is not subject to the protection of section 425.13 of the Code of Civil Procedure, which prohibits punitive-damages claims against health-care providers without prior court permission.

The court held that section 425.13 did not apply to claims against health plans, which are not considered health-care providers under California law.   The court also held that the allegations of the plaintiff’s complaint were sufficient to allege a bad-faith claim against Kaiser in its role as a health plan, and was not merely an attempt to hold the health plan vicariously liable for the medical negligence of the doctors it employed.  In the Rahm case, Anna Rahm, then 17, was complaining to Kaiser doctors for months about unrelenting back pain.  Her family repeatedly requested that Kaiser perform an MRI to determine the cause of the pain, but the Kaiser physicians delayed.  As a result, they did not discovery that Anna was suffering from osteosarcoma, and she lost her leg, and part of her pelvis and spine.

Download California Court of Appeal Opinion in Kaiser Foundation Health Plan, Inc. v. Superior Court (Rahm)(2012) Cal.App.4th  (.pdf)


Our Legal Services

Southern California appeals attorney, Jeffrey Isaac Ehrlich, is an appellate specialist certified by the State Bar of California’s Committee on Legal Specialization. He is the principal of the Ehrlich Law Firm, in Los Angeles County, Encino, California.

Ehrlich Law Firm wins landmark negligence ruling in California Supreme Court

California Writs and Appeals Lawyer

Ehrlich Law Firm wins landmark negligence ruling in California Supreme Court

California Supreme Court SealIn a unanimous decision the California Supreme Court reversed a JNOV ordered by the Court of Appeal in Cabral v. Ralph’s Grocery Co. The decision reinstates a wrongful death judgment on behalf of the family of Adelmo Cabral, who was killed when his car veered off the freeway and collided with the back of a Ralph’s tractor-trailer rig that had been parked 16 feet from the freeway while its driver had a snack.

The jury held that Ralphs’ was 10% at fault for the crash, but the appellate court reversed, finding that the crash was “unforseeable” and that truck drivers therefore owed no duty to passing freeway motorists in the manner in which they parked their trucks as long as they were out of the travel lanes. The Supreme Court rejected all of the appellate court’s reasoning. The decision is important because it expressly curtails the practice used by trial and appellate courts with increasing frequency to decide negligence cases as a matter of law by finding that the defendant owed the plaintiff no duty of care on the particular facts of the case.

The Court held that the decision that no duty of care is owed — which is more accurately framed as a finding that an exception should be made to the general duty of care imposed on all persons by California law — “is to be made on a more general basis suitable to the formulation of a legal rule.” As a result, the Cabral decision will mean that more negligence cases in California will be decided by juries, based on the specific facts of the case, and not by courts based on a finding that no duty exists.

Read The Decision (.pdf)

LA Checker Cab Cooperative, Inc. v. First Specialty Ins. Co. Depublication Request Granted

LA Checker Cab Cooperative, Inc. v. First Specialty Ins. Co. Depublication Request Granted

LA Checker Cab LogoOn August 11, 2010, Jeffrey Isaac Ehrlich, principal of The Ehrlich Law Firm filed a depublication request  (L.A. Checker Cab Cooperative, Inc. v. First Specialty Ins. Co.) on behalf of the Consumer Attorneys Association of California.  (Two other depublication requests were also filed.)   On October 27, 2010, the California Supreme Court granted the request for depublication of the L.A. Checker Cab decision.

Depublication of Court of Appeal decisions by the Supreme Court of California used to be a common practice, but in recent years has become quite uncommon.  In the last few years roughly 12 cases per year have been ordered depublished.

The significance of the depublication of LA Checker Cab is this:  the decision effectively eliminated all insurance coverage in California for any claims of negligent supervision or negligent hiring, because the court held that such claims did not qualify as an “occurrence” that is necessary to trigger coverage.   Depublication of the decision means that the decision cannot be cited as precedent in California courts, and therefore California trial courts are not required to follow it.

Read Depublication Request: L.A. Checker Cab Cooperative, Inc. v. First Specialty Ins. Co.; 186 Cal. App. 4th 767, No. B213948 (Second District iv. One); Order published: July 13, 2010


Why you need an attorney with writ petition experience

The lawyer who petitions for a writ must therefore be able to show the Court that the issue presented is (a) interesting, and (b) important. For this reason, the odds of being able to successfully obtain writ review often depend on the skill of the lawyer presenting the writ petition. At the Ehrlich Law Firm, we have experience with drafting persuasive writ petitions, and have enjoyed success in obtaining writ review for our clients at far higher than the overall success rate for writ petitions.

For example, in Elvira v. Superior Court (2007) B200184, we successfully obtained a writ challenging the trial court’s sustaining of a demurrer to plaintiff’s complaint.  In DeBruyn v. Superior Court (2008) 158 Cal.App.4th 1213, we convinced the Appellate Court to consider the issue of whether an insurance policy that purported to bar all mold-related claims, regardless of how caused, was consistent with California law.  And in Medeiros v. Superior Court (2007) 146 Cal.App.4th 1008, we obtained a writ for a client who had been enrolled in her employer’s health plan electronically, without being given the disclosure concerning the plan’s use of arbitration that were required on the application by state law.  In its published opinion, the court held that insurers could not circumvent this law by doing away with the application.

Contact our appellate law firm today to learn more about our legal writing services for attorneys.

Ehrlich Law Firm wins landmark insurance decision in California Supreme Court

California Writs and Appeals Attorney

Ehrlich Law Firm wins landmark insurance decision in California Supreme Court

California Supreme Court SealA unanimous California Supreme Court held that a “severability of insurance” clause made a homeowner’s liability policy ambiguous where the insurer sought to rely on an exclusion that withdrew coverage for all insureds under the policy based on the intentional acts of one insured. Plaintiff Scott Minkler holds a $5 million judgment against David Schwartz, who molested him, and against David’s mother, Betty, for negligently failing to stop the wrongful conduct. Betty’s insurer rejected coverage, arguing that the intentional-acts exclusion in the policy, which withdrew coverage for any claim arising from the intentional acts of “an” insured, applied to the claims against Betty because David’s conduct was intentional.

The Supreme Court adopted the approach advanced by the Ehrlich Law Firm, finding that the policy’s severability provision, which states that “this insurance applies separately to each insured” would lead a reasonable insured to conclude that he or she would be treated as the only insured under the policy. Because most liability policies have severability clauses, the Minkler case may substantially broaden coverage in California for failure-to-supervise claims. Minkler v. Safeco (2010) __ Cal.4th __.)


A lawyer’s lawyer

Our principal attorney is Jeffrey Isaac Ehrlich, a certified appellate specialist by the State Bar of California’s Committee on Legal Specialization. Few attorneys can match Mr. Ehrlich’s appellate experience.  His skill is in analyzing complex legal and factual issues, and presenting them to the court in a clear, persuasive manner. We can help plaintiff’s attorneys with any appellate matter in either the state or the federal appellate courts.

We can defend favorable verdicts and attack unfavorable ones. We can draft writ petitions to seek appellate review of a devastating – but unappealable – trial court ruling, or respond to petitions filed by an opponent. We are experienced in seeking reversals in cases where the defendant has prevailed on summary judgment.

Benefits of hiring The Ehrlich Law Firm to handle your appeal

When large corporate defendants win or lose a jury verdict, or any type of major case at the trial level, they often bring in appellate specialists to handle the post-trial briefing. Why?

Sophisticated clients understand that the skills that win trials are not necessarily the skills that win appeals, and that appellate specialists are often best prepared to defend or attack a verdict on appeal.

Our Legal Services

Ehrlich Firm Prevails in California Supreme Court case

California Writs and Appeals

Ehrlich Law Firm prevails in California Supreme Court on case involving important issues of California civil-writ practice and procedure.

California Supreme Court SealIn a closely-watched case involving civil-writ procedure in California, the  California Supreme Court adopted the position advocated by the Ehrlich Law Firm, and held that appellate courts can properly issue so-called “speaking” or “suggestive” Palma notices when they are inclined to issue a peremptory writ of mandate in the first instance. A Palma notice informs the parties that an appellate court is inclined to grant a peremptory writ in the first instance. A speaking Palma notice goes further, and explains why the Court is taking the position it takes, and often directs the trial court to change its order. The Supreme Court held that a speaking Palma notice is proper, but that trial courts should hold a hearing before changing an order in response to such a notice. (Brown, Winfield & Canzoneri v. Superior Court (Great American Ins. Co.)(2010) 47 Cal.4th 1233.)


Benefits of hiring The Ehrlich Law Firm to handle your appeal

When large corporate defendants win or lose a jury verdict, or any type of major case at the trial level, they often bring in appellate specialists to handle the post-trial briefing. Why?

Sophisticated clients understand that the skills that win trials are not necessarily the skills that win appeals, and that appellate specialists are often best prepared to defend or attack a verdict on appeal.

Effective lawyering requires a wealth of skills, and most lawyers gravitate to what they enjoy and what they are good at. While most lawyers are called on to write in the course of their practice, few devote themselves to becoming accomplished legal writers.

Only those with a keen interest in writing are likely to take seminars on writing, read books on effective written advocacy, seek out expert editors and subject their writing to blunt criticism, and then practice the lessons learned on countless motions, oppositions, and briefs.

A look at our bookshelf reveals where our interests lie. It is filled with books on writing, usage dictionaries, and written advocacy. We care about writing well, and have devoted considerable effort to develop and maintain our writing skills. [Sample briefs]

As a result of this hard work, and more than 20 years of practice, we are recognized as being among the best plaintiffs’ appellate firms in California. This is why the Consumer Attorneys of Los Angeles – the third largest trial lawyer association in the nation – recognized Jeffrey Isaac Ehrlich its 2004 appellate lawyer of the year.

This is also why Michael Bidart of Shernoff Bidart Echeverria LLP, one of the most successful plaintiff’s attorneys in the nation (and our former law partner) uses us as his appellate counsel.


Our Legal Services

Southern California appeals attorney, Jeffrey Isaac Ehrlich, is an appellate specialist certified by the State Bar of California’s Committee on Legal Specialization. He is the principal of the Ehrlich Law Firm, in Encino, Los Angeles County, California.

 

Ehrlich Law Firm obtains important victory in asbestos lawsuit

California Writs and Appeals Attorney

Ehrlich Law Firm obtains important victory in asbestos lawsuit; California Supreme Court then grants review

Asbestos warningWaters, Kraus & Paul, with one of the premier asbestos-litigation practices in the U.S., hired the Ehrlich Law Firm to argue an important products-liability case, O’Neil v. Crane Co. in the Court of Appeal, Second District, Div. 5.

The issue in O’Neil was whether sailors injured by asbestos released during the maintenance of valves and pumps that were manufactured to contain asbestos within them, and that were insulated with asbestos, could be held liable on theories of strict products liability and negligence, even if the asbestos material in the equipment had been replaced with other asbestos material during the product’s life.

In Taylor v. Elliott Turbomachinery Co., Inc. (2009) 171 Cal.App.4th 564, the Court of Appeal , First District, held that the manufacturers could not be held liable because the asbestos was not “their” product.

Ehrlich convinced the court not to follow Taylor, and in a written decision the court held that Taylor had been wrongly decided.  (O’Neil v. Crane Co. (2010) 177 Cal.App.4th 1019.)  The Supreme Court later granted review to resolve the conflict between the positions advocated in O’Neil and Taylor.  Ehrlich is expected to argue the matter in the California Supreme Court.


Benefits of hiring The Ehrlich Law Firm to handle your appeal

When large corporate defendants win or lose a jury verdict, or any type of major case at the trial level, they often bring in appellate specialists to handle the post-trial briefing. Why?

Sophisticated clients understand that the skills that win trials are not necessarily the skills that win appeals, and that appellate specialists are often best prepared to defend or attack a verdict on appeal.

Effective lawyering requires a wealth of skills, and most lawyers gravitate to what they enjoy and what they are good at. While most lawyers are called on to write in the course of their practice, few devote themselves to becoming accomplished legal writers.

Only those with a keen interest in writing are likely to take seminars on writing, read books on effective written advocacy, seek out expert editors and subject their writing to blunt criticism, and then practice the lessons learned on countless motions, oppositions, and briefs.

A look at our bookshelf reveals where our interests lie. It is filled with books on writing, usage dictionaries, and written advocacy. We care about writing well, and have devoted considerable effort to develop and maintain our writing skills. [Sample briefs]

As a result of this hard work, and more than 20 years of practice, we are recognized as being among the best plaintiffs’ appellate firms in California. This is why the Consumer Attorneys of Los Angeles – the third largest trial lawyer association in the nation – recognized Jeffrey Isaac Ehrlich its 2004 appellate lawyer of the year.

This is also why Michael Bidart of Shernoff Bidart Echeverria LLP, one of the most successful plaintiff’s attorneys in the nation (and our former law partner) uses us as his appellate counsel.

Our Legal Services


Southern California appeals attorney, Jeffrey Isaac Ehrlich, is an appellate specialist certified by the State Bar of California’s Committee on Legal Specialization. He is the principal of the Ehrlich Law Firm, in Encino, Los Angeles County, California.

Ehrlich Law Firm wins landmark ruling against Blue Cross of California

Sacramento Appeals Attorney

Ehrlich Law Firm wins landmark ruling establishing that health-plan administrators are subject to suit for negligent administration of the health plan

California Courts of Appeal SealJudge David Mintz had been fighting lung cancer for years. When it recurred, his doctors said his only chance was a treatment called radio-frequency ablation (“RFA”). Blue Cross was the third-party administrator of Mintz’s CalPERS health plan. Blue Cross denied the claim for RFA on the grounds that it was excluded as experimental. But it failed to notify Mintz that under state law, the plan was required to pay for experimental treatment if an independent medical review determined it would be more beneficial for the patient than conventional treatment. Mintz was unable to obtain RFA, and died while his lawsuit was pending.

The trial court dismissed his case on demurrer, and the Court of Appeal reversed, finding that third-party administrators can be held liable for their negligent administration of the plan. Mintz v. Blue Cross of California, 172 Cal.App.4th 1594 (2d Dist. 2009).


Benefits of hiring The Ehrlich Law Firm to handle your appeal

When large corporate defendants win or lose a jury verdict, or any type of major case at the trial level, they often bring in appellate specialists to handle the post-trial briefing. Why?

Sophisticated clients understand that the skills that win trials are not necessarily the skills that win appeals, and that appellate specialists are often best prepared to defend or attack a verdict on appeal.

Effective lawyering requires a wealth of skills, and most lawyers gravitate to what they enjoy and what they are good at. While most lawyers are called on to write in the course of their practice, few devote themselves to becoming accomplished legal writers.

Only those with a keen interest in writing are likely to take seminars on writing, read books on effective written advocacy, seek out expert editors and subject their writing to blunt criticism, and then practice the lessons learned on countless motions, oppositions, and briefs.

A look at our bookshelf reveals where our interests lie. It is filled with books on writing, usage dictionaries, and written advocacy. We care about writing well, and have devoted considerable effort to develop and maintain our writing skills. [Sample briefs]

As a result of this hard work, and more than 20 years of practice, we are recognized as being among the best plaintiffs’ appellate firms in California. This is why the Consumer Attorneys of Los Angeles – the third largest trial lawyer association in the nation – recognized Jeffrey Isaac Ehrlich its 2004 appellate lawyer of the year.

This is also why Michael Bidart of Shernoff Bidart Echeverria LLP, one of the most successful plaintiff’s attorneys in the nation (and our former law partner) uses us as his appellate counsel.

Our Legal Services


Southern California appeals attorney, Jeffrey Isaac Ehrlich, is an appellate specialist certified by the State Bar of California’s Committee on Legal Specialization. He is the principal of the Ehrlich Law Firm, in Encino, Los Angeles County, California.

Ehrlich Law Firm wins insurance bad-faith victory in California Supreme Court

California Writs and Appeals Attorney

Ehrlich Law Firm wins insurance bad-faith victory in California Supreme Court

California Supreme Court SealInsurance companies in California can no longer prevail in bad-faith lawsuits brought by their policyholders simply by showing that there was a “dispute” about whether the insurer should pay the claim. In Wilson v. 21st Century Ins. Co. (2007) 42 Cal.4th 713, the Supreme Court reined in the so-called “genuine dispute rule” that had become the insurance industries’ most potent defense in bad-faith cases, holding that the rule only applied at the summary-judgment stage, and then only in cases where a jury would be unable to make a finding that the insurer had acted unreasonably.

The Wilson ruling makes it much harder for insurers to obtain summary judgment in bad-faith lawsuit.


Why hire The Ehrlich Law Firm?

Mr. Ehrlich has briefed and argued hundreds of appeals, in the following courts: The U.S. Supreme Court; the U.S. Court of Appeals for the 3rd, 4th, 5th, 6th, 7th, 9th and 11th Circuits; the California Supreme Court; the Virginia Supreme Court; the Maryland Court of Special Appeals, the Louisiana Court of Appeals, and the California Court of Appeal. In California, Mr. Ehrlich has handled appeals in the appellate courts sitting in San Francisco (First District), Los Angeles (Second District), Sacramento (Third District) San Diego (Fourth District, Div. 1), Riverside (Fourth District, Div. 2), Santa Ana (Fourth District, Div. 3), Ventura (Second District, Div. 6),,, and Fresno (Fifth District) – in sum, every appellate court in the State except for the Sixth District, which sits in San Jose.

Both the California and the federal appellate system dispose of the vast bulk of their civil appeals in unpublished decisions. Fewer than 25% of all appeals decided are decided by published decisions that have precedential value. Mr. Ehrlich has over 55 published appellate decisions in the state and federal courts. Very few appellate lawyers in California have comparable experience with civil appeals.

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Ehrlich Law Firm wins writ proceeding invalidating Health Net arbitration agreement

California Writs and Appeals

Ehrlich Law Firm wins writ proceeding invalidating Health Net arbitration agreement

California Court of Appeal Second Appellate District Los AngelesJanuary 2007 – The Court of Appeal in Los Angeles has reversed a trial court’s order requiring that Mary Medeiros arbitrate her claims against Health Net, arising from the company’s failure to provide her with timely medical care. Even though Health Net’s enrollment form failed to comply with the mandatory disclosure requirements concerning arbitration clauses, the trial court ordered the case to arbitration.

The Ehrlich Law Firm filed a writ of mandate, which was granted in a published opinion. (Medeiros v. Superior Court (Health Net) (2007) 146 Cal.App.4th 1008. Medeiros is a victory for public employees, because it held that health plans that provide coverage through public agencies must comply with the arbitration-disclosure requirements in the Health & Safety Code and the Insurance Code.


Why you need an attorney with writ petition experience

The lawyer who petitions for a writ must therefore be able to show the Court that the issue presented is (a) interesting, and (b) important. For this reason, the odds of being able to successfully obtain writ review often depend on the skill of the lawyer presenting the writ petition. At the Ehrlich Law Firm, we have experience with drafting persuasive writ petitions, and have enjoyed success in obtaining writ review for our clients at far higher than the overall success rate for writ petitions.

For example, in Elvira v. Superior Court (2007) B200184, we successfully obtained a writ challenging the trial court’s sustaining of a demurrer to plaintiff’s complaint.  In DeBruyn v. Superior Court (2008) 158 Cal.App.4th 1213, we convinced the Appellate Court to consider the issue of whether an insurance policy that purported to bar all mold-related claims, regardless of how caused, was consistent with California law.  And in Medeiros v. Superior Court (2007) 146 Cal.App.4th 1008, we obtained a writ for a client who had been enrolled in her employer’s health plan electronically, without being given the disclosure concerning the plan’s use of arbitration that were required on the application by state law.  In its published opinion, the court held that insurers could not circumvent this law by doing away with the application.

Contact our law firm today, to learn more about our legal services.

Benefits of hiring The Ehrlich Law Firm to handle your appeal

When large corporate defendants win or lose a jury verdict, or any type of major case at the trial level, they often bring in appellate specialists to handle the post-trial briefing. Why?

Sophisticated clients understand that the skills that win trials are not necessarily the skills that win appeals, and that appellate specialists are often best prepared to defend or attack a verdict on appeal.

Our Legal Services