Denied Insurance Claims Lawyer: Helping Secure Benefits in Boston, Massachusetts

Boston ERISA attorney can help

“For the most part insurance companies hold up their end of the bargain but sometimes they don’t. When this happens, I get involved. It’s like David & Goliath, I fight for the underdog. I help my clients battle the big insurance company giants and help them receive the benefits they paid for and deserve. My objective is your objective – helping you secure the insurance benefits you paid for and you deserve.” -Jonathan Feigenbaum

Dealing with an insurance company can be exhausting. For more than 25 years I have been assisting people with their claims for long-term disability, health care, life insurance and other benefits whether secured through their employer or purchased on the individual market. I know how important your claim is whether it’s your financial future for you and your family, or your health outcome.

I want to help you. To me, you’re not just another file or case number. That is one reason I enjoy my job as an attorney representing individuals rather than institutions. I understand that your integrity is under attack. I grasp that you planned for an unlikely event and now when you need insurance coverage, you are not being treated with the respect and dignity that you deserve.

In this modern age, staying in touch by email, text, skype or telephone is easy. I’m not hard to find. Realizing that one of the biggest complaints about attorneys is not staying in touch, I strive to respond to you promptly.

Whether your claim falls under the Employee Retirement Income Security Act (ERISA), or you have a claim under an individual insurance policy, my goal has, and is the same as yours – getting you paid or making the insurance company pay for your medical care or other benefits. In reaching your objective, I want to understand you, work collaboratively with you and listen to you, rather than talk at you.

(If you are more interested in my legal pedigree, leadership roles as a lawyer and case accomplishments, skip ahead)

Regardless of the size of a claim, whether it’s $50 per month, or $80,000 per month, I am ready to assist. I have represented hundreds of clients, reviewed thousands of claims and I have recovered tens of millions of dollars for clients.

Recognizing that litigation is expensive, I handle most cases on a contingency fee basis. In most instances, I advance the costs of litigation too. If you don’t get paid, I don’t get paid.

My practice is national.  I litigate insurance denials in the state trial courts, the United States District Courts, the United States Circuit Courts of Appeals and state Supreme Courts. I have filed briefing in the US Supreme Court on behalf of a charitable organization. In many locations outside my base in Boston, I collaborate with the small pool of other knowledgeable policyholder attorneys.

Fewer ERISA disability, health and life insurance cases settle before judgment. The reasons for this trend include the fact that there is no jury trial and limited damages, and the case is brought into court only after extensive administrative review by the benefit denier. An ERISA fiduciary, who is often a profit making insurance company, is permitted to control the flow of information, act as a judge and defendant all to the detriment of the plan beneficiary. There is only a small downside for insurance companies in proceeding to judgment. The economics are that it is cost efficient for insurers to take most cases to judgment. The worst case for an insurer is that the insurer pays past due benefits, interest, some amount of attorneys’ fees and costs and its own attorneys’ fees. An insurer faces relatively little excess exposure, and does not run the risk of bad faith or punitive damage award or any unknown that a jury may impose. These are some of the reasons but not all.

Over the years, insurers have become more sophisticated in their arguments, involving plan interpretation, standards of review, evidentiary issues, application of the United States Department of Labor Regulations, medical issues, vocational issues and the like. While disability cases, for example, may seem straightforward, the complexities of preemption, lack of jury trial, lack of compensatory and punitive damages and the unique standard of proof issues, make even the most garden variety ERISA claims into complex and generally undesirable ones.

Boston has been my adopted home for more than 30 years.  During my childhood, we moved around because my father was an academic. This provided some great opportunities for our family. When I was in the 6th grade we lived Dublin, Ireland and in the 11th grade, we lived in Ankara, Turkey. To this day I travel a great deal; I have circumnavigated the globe many times.

Since 3rd grade, I consider a small town bordering Washington, D.C. the place where I grew-up. I am still the proud owner of an authentic Washington Senators baseball T-shirt that I received in 4th grade. Although it has some holes, it’s an original to the time of the great Frank “Hondo” Howard. The “Gentle Giant” had a well deserved reputation as the face of baseball and all around nice guy except to the pitchers he faced. That is the kind of role model I choose to emulate.

As my father says, “Everyone needs a hobby or two or more.” I have a few beside traveling, including playing racquet sports and doing anything and everything in the ocean. I like movies, so I made one with some other friends. Take a look, www.bluffthemovie.com.

Significant Cases

  • Gross v. Sun Life Assur. Co. of Canada, 880 F.3d 1 (1st Cir. 2018) (Affirming District Court’s judgment awarding more than 10 years of past due benefits through the date of judgment, and reversing the District Court for discounting attorney’s fees and failing to explain low rate for prejudgment interest)
  • Stephanie C. v. Blue Cross Blue Shield of Massachusetts HMO Blue, Inc., 813 F.3d 420 (1st Cir. 2016) (Compelling First Circuit case holding a grant of discretionary decision-making authority in an ERISA plan must be couched in terms that unambiguously indicate that the claims administrator has discretion to construe the terms of the plan and determine whether benefits are due in particular instances. Employee Retirement Income Security Act of 1974 et seq.)
  • Gross v. Sun Life Assur. Co. of Canada, 763 F.3d 73 (1St Cir. 2014) (leading Circuit Court case natioinwide holding remand to administrator was sufficient success on merits to establish participant’s eligibility for  attorney’s fees even if no benefits awarded)
  • Mead v. Reliastar Life Ins. Co., 768 F.3d 102 (2d Cir. 2014) (As matter of first impression in the Second Circuit, district court’s order remanding issues to plan administrator was not final and appealable)
  • Auto Flat Car Crushers, Inc. v. Hanover Ins. Co., 469 Mass. 813 (2014) (Filed Amicus Brief for United Policyholders in support of Auto Flat where Supreme Judicial Court held acceptance of a defendant’s tender of payment of insurance policy does not vitiate a claim under consumer protection statute as a matter of course for multiple damages)
  • Gross v. Sun Life Assur. Co. of Canada, 734 F.3d 1 (1st Cir. 2013) (Reversing prior precedent and now holding satisfactory to us” language as used in ERISA plan did not state with sufficient clarity that the plan administrator was to make a judgment largely insulated from judicial review by reason of being discretionary, and therefore plan administrator’s rejection of participant’s claim for benefits was subject to de novo review)
  • Denmark v. Liberty Life Assur. Co. of Boston, 566 F.3d 1 (1st Cir. 2009) (leading First Circuit case holding in a review of a denial of ERISA benefits, a structural conflict must be accorded weight, albeit not necessarily dispositive weight, in the standard-of-review equation. Employee Retirement Income Security Act of 1974, § 2 et seq.,)
  • Tracia v. Liberty Life Assurance Company of Boston, 164 F.Supp.3d 201 (D. Mass. 2016) (ERISA Administrator failed to provide required notice of type of evidence necessary to support participant’s claim resulting in remand)
  • Petrone v. Long Term Disability Income Plan for Choices Eligible Employees of Johnson & Johnson and Affiliated Companies, 935 F.Supp.2d 278, 293 (D. Mass. 2013) (Held ERISA administrator cannot simply ignore contrary evidence, or engage with only that evidence which supports his conclusion)
  • Kaufmann v. Prudential Ins. Co. of America, 840 F.Supp.2d 495 (D.N.H. 2012) (Claimant in an action for benefits under an ERISA plan did not have to comply with an administrative appeal procedure that was included in a summary plan description (SPD) but not in the written instrument that established the plan; the SPD expressly declared that its provisions were not part of the plan)
  • McDonough v. Federal Ins. Co., 2012 WL 4060564, at *5 (D. Mass. 2012) (Holding while the use of drugs and alcohol may cause some incidental bodily injury to the user, to suggest, that, as a per se rule, every drug and alcohol user intends to injure himself with such use, is divorced from reality)
  • Pinnacle Service Solutions Group, Inc. v. AXA Equitable Life Ins. Co., 831 F.Supp.2d 523 (D. Mass. 2011) (Held that co-defendant did not consent to removal within 30-day removal period, and thus removing defendants’ petition for removal was defective and case must be remanded to state court)
  • Mead v. ReliaStar Life Ins. Co., 755 F.Supp.2d 515, 537 (D.VT 2010) (Holding giving  misleading reasons to discredit the record review of its neurologist is a paradigm of arbitrary and capricious decision-making)
  • Jacoby v. Hartford Life and Acc. Ins. Co., 254 F.R.D. 477 (S.D.N.Y. 2009) (Hartford failed to establish that its claims manual and reference manual were confidential)
  • Smith v. Jefferson Pilot Financial Ins. Co., 245 F.R.D. 45 (D. Mass. 2007) (Case of first impression holding that fiduciary exception to attorney-client privilege applied to communications between insurance company personnel and in-house attorney)
  • Giannone v. Metropolitan Life Ins. Co., 311 F.Supp.2d 168, 178 (D. Mass. 2004) (Holding substantial evidence means actual evidence, not third-hand speculation about the possible cause of a claimant’s disability.
  • Henry v. National Geographic Society, 147 F.Supp.2d 16 (D. Mass. 2001) (Holding Material issues of fact, as to whether trip planners which included photographs originally appearing in driving guides were “related” to guides, precluded summary judgment in suit by photographer claiming that publisher breached contract by using copyrighted photographs in unrelated publication)

Significant Published Works

Employee Benefits Law, Bloomberg BNA, Third Edition, Senior Editor. This is the leading treatise on employee benefits.

Tort Trial & Insurance Practices section of the American Bar Association titled, Did The Supreme Court Flunk Constitutional Law When It Permitted Discretionary Review Of Insured ERISA Benefits Cases?

Notable Speaking Engagements

  • American Bar Association, Annual Tort Trial & Insurance Practices Midwinter Symposium on Insurance and Employee Benefits in Coral Gables, FL discussing ERISA 502(a)(3) CLAIMS AROUND THE CIRCUITS – January 2018
  • American Association for Justice annual convention in Boston on the new Secretary of Labor claims regulations – July 2017
  • Massachusetts Employment Lawyers Association Summary Overview of Short-Term-Disability Benefits, Long-Term-Disability Benefits and Co-ordination with Other Benefits and Settlements Under the Employee   Retirement   Security   Act   of   1974 – March 2017
  • American Bar Association, Annual Tort Trial & Insurance Practices Midwinter Symposium on Insurance and Employee Benefits in Coral Gables, FL discussing the newly adopted Secretary of Labor Claims regulations – January 2017
  • Federal Bar Association (Mass. Chapter)  with US District Court Judge Indira Talwani  at the Massachusetts chapter of the Federal Bar Association on  Changes to the Federal Rules of Civil Procedure since December 1, 2015.- February 2016
  • Ogletree Deakins Nash Smoak & Stewart P.C., client seminar in San Antonio, TX where I spoke on ERISA litigation from a plaintiff’s perspective with Mark Schmidtke of Ogletree Deakins who serves as National ERISA Counsel for several large life, health and disability insurers – May 2015.
  • Massachusetts Employment Lawyers Association on strategies for seeking attorney’s fees in the Federal Courts – November 2014
  • American Bar Association, Joint Committee on Employee Benefits meeting in New Orleans, speaking about drafting plan documents in light of AMARA and MCCUTCHEN
  • American Association for Justice annual convention Insurance Section speaking on Why Personal Injury Attorneys Must Stop Worrying and Learn to Love ERISA or At Least Understand Reimbursement Provisions in Benefit Plans – July 2013
  • American Bar Association,  Annual Tort Trial & Insurance Practices Midwinter Symposium on Insurance and Employee Benefits in St. Pete Beach, FL on Practical Approaches to Conflict Discovery in ERISA Cases: A View from Both Sides of the Aisle – January 2012
  • American Conference Institute, National Advanced Forum on Litigating Disability Insurance Claims featured speaker years 2003, 2005, 2006, 2007, 2008 and 2013,
  • American Association for Justice on litigation strategies after Metropolitan Life Ins. Co. v. Glenn, 128 S.Ct. 2343 (2008) July 2009.
  • Worker Injury Law Group in Scottsdale, AZ speaking about reimbursement claims in connection with ERISA health plans and ERISA long term disability plans October 2009.
  • International DI Society in Las Vegas, NV in October 2009 and again in Boston in October 2010 speaking on “list bill” tactics of insurance companies

Professional Associations and Memberships

  • American College of Employee Benefits Counsel (ACEBC) – Fellow inductee 2017
  • American Association for Justice, Past Chairperson Healthcare and Disability Litigation Group
  • American Association for Justice
    • Past Chair – Insurance Section
    • Past Chair – ERISA, Health & Disability Insurance Litigation Group
    • Bad Faith Litigation Group
    • Insurance Law Section Executive Committee
  • American Bar Association
    • Vice Chair  – Torts Trial and Insurance Practice Section
    • Vice Chair – Employee Benefits General Committee
    • Former Chair and current Vice Chair – Health and Disability Insurance Law Committee
    • Vice Chair – Life Insurance Law Committee
    • Vice Chair – ERISA Committee, Vice Chair
    • Vice Chair – Insurance Academy Task Force, Member 2016-2017
    • Vice Chair – Plaintiffs Practice Standing Committee,  2017-2018
    • Vice Chair – Joint Committee on Employee Benefits
  • American Bar Association – Fellow
  • Boston Bar Association – Steering Committee of Solo/Small Firm Section
  • California Bar Association
  • DC Bar Association
  • Director and ERISA Sub-Committee Chair Massachusetts Employment Lawyers Association (MELA)
  • Massachusetts Academy of Trial Attorneys
  • National Employment Lawyers Association (NELA)
  • Patient Advocate Foundation
  • Southern Trial Lawyers Association

Honors and Awards

  • President’s Award 2014 – Massachusetts Academy of Trial Attorneys
  • American Association for Justice 2009 – Outstanding Newsletter of the Year Editor – Insurance Section

Bar Admissions

  • Massachusetts, 1985
  • District of Columbia, 1987
  • California, 1992
  • U.S. District Court District of Massachusetts
  • U.S. District Court for the Western District of Michigan
  • U.S. District Court of Vermont
  • U.S. Court of Appeals 1st Circuit
  • U.S. Court of Appeals 2nd Circuit
  • U.S. Court of Appeals 6th Circuit
  • U.S. Court of Veterans Appeals

Education

  • Suffolk University Law School, Boston, Massachusetts
  • University of Vermont, Burlington, Vermont