Life, Health and Disability
SWRS’ life, health and disability insurance practice team has represented national insurers, as well as HMOs, TPAs and managed care organizations on a wide variety of matters in federal and state courts. We have experience handling disputes involving coverage; ERISA; state insurance law claims including bad faith, prompt pay and deceptive or unfair practices; stop loss coverage for self-funded plans; fraud and rescission and discount networks.
SWRS has significant litigation experience with stop loss carriers providing excess loss coverage for self-funded health benefit plans. We possess a broad understanding of this industry and the unique issues that are presented in stop loss coverage related to specific and aggregate attachment points, advance pay funding, reimbursement and the complicated interrelation between the plan and the stop-loss contract.
Our team also has long-standing experience reviewing, analyzing, and defending ERISA benefit determinations, including decisions regarding life, accidental death and dismemberment, long- and short-term disability, and other welfare benefits. We represent plan sponsors, fiduciaries, administrators, carriers, and others involved in employee benefit plan and plan asset administration.