Life, Health, Disability and ERISA

Smith Moore Leatherwood's Life, Health, Disability and ERISA Team enjoys a national reputation for excellence.

The Team is comprised of attorneys who have represented life, health and disability insurance companies, ERISA plan sponsors and third-party administrators in hundreds of cases in federal and state courts throughout the Southeast.  They have defended a broad variety of claims brought under ERISA, RICO, and the ADA, class actions, discriminatory underwriting claims, allegations of agent misconduct, and breach of contract claims for the recovery of life, accidental death, disability and health insurance benefits.

The Team represents more life, health and disability insurance companies than any other law firm in the Southeast, and its lawyers are leaders in organizations such as the Life, Health and Disability Committee of the Defense Research Institute and the Life Insurance Committee, Health and Disability Committee, and Employee Benefits Committee of the Tort Trial & Insurance Practice Section of the American Bar Association.  They are frequent speakers at national seminars on life, health, disability and ERISA matters.

Representative cases:

  • Moorman v. UnumProvident Corp., 464 F.3d 1260 (11th Cir. 2006) (group disability coverage governed by ERISA at issue)
  • Dixon v. Life Ins. Co. of North America, 389 F.3d 1179 (11th Cir. 2004) (accidental death due to coronary event during automobile accident under ERISA plan at issue )
  • Cowart v. Metropolitan Life Ins. Co., 444 F. Supp. 2d 1282 (M.D. Ga. 2006) (safe harbor exemption and individual disability policy governed by ERISA in dispute)
  • Karp v. Guardian Life Ins. Co. of Am., 456 F. Supp. 2d 1375 (S.D. Ga.), aff'd, 199 Fed.Appx. 870 (11th Cir. 2006) (termination of employment and award of Social Security disability benefits satisfying definition of "qualifying event" under COBRA at issue)
  • Perry v. Unum Life Ins. Co. of Am., 353 F. Supp. 2d 1237 (N.D. Ga. 2005) (dispute regarding whether piercing corporate veil was warranted, absent allegation that subsidiary was insolvent, and liability of parent company for tortious interference with contract)
  • Kocer v. New York Life Ins. Co., 340 F. Supp. 2d 1351 (N.D. Ga. 2004) (entitlement of insured to total disability benefits, and residual disability benefit claim involving contractual limitation period at issue)
  • Transamerica Occidental Life Ins. Co. v. Miles, 317 F. Supp. 2d 1373 (N.D. Ga. 2003), aff'd, 107 Fed.Appx. 184 (11th Cir. 2004) (dispute regarding whether life insurance policy became effective due to change in applicant's health after policy was received by agent but before policy was delivered to applicant)
  • Worsham v. Provident Companies, Inc., 249 F. Supp. 2d 1325 (N.D. Ga 2002) (dispute regarding merger clause of disability policy baring fraud and RICO claims based on alleged pre-contractual misrepresentations)
  • Yessick v. The Midland Life Ins. Co., 178 F. Supp. 2d 1301 (N.D. Ga. 2001) (dispute regarding whether insurer's usual business procedures warranted delivery of notice of termination of life insurance policy)
  • Suarez v. Massachusetts Mutual Life Ins. Co., 132 F. Supp. 2d 1382 (N.D. Ga), aff'd, 232 F.3d 216 (11th Cir. 2000) (determination of whether loss of medical license was legal disability, precluding recovery of disability benefits based on subsequent factual disability)
  • McAfee v. Transamerica Occidental Life Ins. Co., 106 F. Supp. 2d 1331 (N.D. Ga. 2000), aff'd, 252 F.3d 1362 (11th Cir. 2001), rehearing denied, 268 F.3d 1069 (11th Cir. 2001), cert. denied, 534 U.S. 994 (2001) (dispute regarding whether death by gunshot wounds during standoff with police was accidental under ERISA plan)
  • Adair v. Boston Mut. Life Ins. Co., 24 F. Supp. 2d 1380 (M.D. Ga. 1998) (dispute regarding whether insured's death from apparent medication overdose was by accidental means)
  • Hobbs v. Principal Financial Group, Inc., 230 Ga. App. 410, 497 S.E.2d 243 (1998) (dispute regarding whether insurer was liable for fraud of independent agent)
  • Glass v. United of Omaha Life Ins. Co., 33 F.3d 1341 (11th Cir. 1994) (life insurance conversion policy governed by ERISA at issue, along with whether insurer was liable for benefits under estoppel or waiver theories)
  • Cosby v. Transamerica Occidental Life Ins. Co., 860 F. Supp. 830 (N.D. Ga. 1993), aff'd, 16 F.3d 1232 (11th Cir. 1994) (dispute regarding whether insured's breach of common law duty to advise insurer of change in health warranted recinding of life insurance)
  • Lincoln National Life Ins. Co. v. Davenport, 201 Ga. App. 175, 410 S.E. 2d 370 (1991) (liability for intentional infliction of emotional distress arising from denial of claim for disability benefits at issue)
  • Prudential Ins. Co. of Am. v. Nessmith, 174 Ga. App. 39, 329 S.E. 2d 249 (1985) (dispute regarding whether insurer waived policy's lapse provisions by acceptance of two prior late premium payments)
  • Keaten v. Paul Revere Life Ins. Co., 648 F.2d 299 (5th Cir. 1981) (dispute regarding whether disability due to pre-manifested sickness was within coverage of policy).