ERISA

Generally, when an employer promises insurance benefits to its employees, any claim made under that insurance is governed by the Employee Retirement Income Security Act of 1974, more generally known as ERISA.  Many lawyers, even those who specialize in insurance law, are reluctant to bring cases governed by ERISA, because it is a complex statute with many specialized rules.  

Donahue & Horrow are not afraid to take on these cases, because the disability insurance team has decades of experience litigating ERISA claims.  Indeed, Donahue & Horrow recently filed a lawsuit against UNUM Life Insurance Company, a billion-dollar insurance company, seeking ERISA benefits for their client.

Our client, a Licensed Vocational Nurse, worked for a healthcare company and enjoyed her job.  Unfortunately, as of March 2023, she was forced to admit to herself that she could no longer continue working due to a variety of comorbid conditions, including, but not limited to low back pain with right lower extremity radiculopathy, anxiety, neuropathy, fibromyalgia, chronic neck pain, and bilateral carpal tunnel syndrome.  She accordingly filed two insurance claims:  one for monthly disability benefits and one for a waiver of the premium for her life insurance policy.  

UNUM initially approved both claims; however, in July 2025, UNUM suddenly and improperly denied both benefit claims.  In the denial letters, UNUM failed to document any improvement in her condition sufficient to justify its new position that she was capable of returning to work.  While our client’s treating physicians continued to support her claims, UNUM cast those opinions aside in favor of reports authored by their own, in-house physicians indicating that our client could return to work.

The medical professionals on whom UNUM relied to support the claim decisions never spoke with or examined our client.  Instead, they based their opinions solely on a review of medical records, all of which supported her assertion that she was unable to continue working.  Despite failing to explain why UNUM believed that the opinions of non-examining physicians should carry more weight than our client’s examining and treating medical professionals, UNUM decided to place the opinions of its employees above all others. 

Donahue & Horrow accordingly filed an ERISA lawsuit in the Central District of California in Downtown Los Angeles.  Michael Horrow and his team will work to ensure that UNUM is held responsible for improperly denying our client’s claims for disability and waiver of premium benefits. 

If your disability or life insurance benefits have been denied under an employer-sponsored plan, call Donahue & Horrow LLP at (877) 664-5407 for a free consultation.  Michael Horrow and his team are ready to fight for you.