Doctor Awarded Disability Benefits and Attorneys’ Fees After Three-and-a-Half-Year Battle – Victory at the Ninth Circuit

In October 2019, Donahue and Horrow LLP sued the nation’s biggest insurance company—Unum Life Insurance Company—on behalf of a doctor whose claim for disability benefits was unfairly denied. While there was no dispute that the doctor suffered from Chronic Migraine Disorder and
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Mass Shooting Victim Awarded $420K Settlement For Disability Insurance Dispute

In the aftermath of a tragic mass shooting, an ultrasound technologist was left with severe physical and psychological injuries preventing her from returning to work. Despite her treating physicians and the Social Security Administration agreeing she could not work, her insurance company
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Cabral v. Ralphs – $4.8 Million Jury Verdict Reinstated

Adelelmo Cabral was driving home from work on the Eastbound I-10 freeway when he lost control of his car, crossed several lanes of traffic, and collided with the rear of a Ralph’s tractor-trailer rig that had been parked on the freeway shoulder, about 16-feet from the edge of the right lane. The area where the truck had been parked was marked by CalTrans with an “Emergency Parking Only” sign. The Ralph’s driver had stopped there to have a snack. He chose that specific area because it was shaded. Michael Horrow represented Mr. Cabral’s wife and children in a wrongful-death case against Ralph’s.

At trial, Mr. Horrow obtained a jury verdict in favor of the Cabral family, which found that the Ralph’s driver had been negligent in parking his truck adjacent to the freeway, and he also persuaded the trial court to deny Ralph’s motion for judgment notwithstanding the verdict. On appeal, however, the Court of Appeal reversed the judgment in favor of the Cabral family, finding that Ralphs could not be held liable because its driver owed no duty of care to passing motorists with respect to where he parked his truck alongside the freeway.

The California Supreme Court agreed to hear the case, and reversed the Court of Appeal, reinstating the jury verdict.

Welle v. Provident Life & Accident Ins. Co.

An OB/GYN retained Michael Horrow to represent her in an insurance bad-faith lawsuit in federal court to challenge Provident’s denial of her claim for long-term disability benefits. As part of her bad-faith claim, Mr. Horrow served a discovery request on Provident asking it to provide information about the bonus awards and performance ratings for the employees who denied Welle’s claim. The insurer refused to provide this information, claiming that the request was improper for various reasons. Mr. Horrow challenged this position and the federal court ruled that Provident was obligated to provide the information he had requested, which the court found was relevant to the bad-faith claim and not unduly burdensome or overbroad.

Sullivan v. Prudential Ins. Co. of America

Michael Horrow represented Otilia Sullivan in an ERISA action in federal court to recover long-term disability benefits. One of the disputed issues in the case was whether the district court should evaluate the plan’s denial of benefits under the de novo or the abuse-of-discretion standard of review. The plan argued that because the “Summary Plan Description” (SPD) document that it provided to plan members to summarize the plan benefits said that the abuse-of-discretion standard applied, the court should apply that standard. But Michael Horrow pointed out that, notwithstanding the statement in the SPD about the administrator having discretion, the plan itself contained no such grant of authority. Mr. Horrow convinced the district court that, in the absence of a grant of discretion in the plan document itself, a statement in the SPD to that effect was insufficient. As a result, the court applied the de novo standard of review.

Cabana v. Reliance Standard Ins.

April Cabana suffered back and leg injuries in an automobile accident. She succeeded in obtaining long-term disability (LTD) benefits from her employer’s disability plan, which was administered by Reliance. After the accident Cabana received extensive treatment on her back, undergoing two spinal-fusion surgeries. Yet she continued to have severe pain. Reliance agreed that she was totally disabled under the “own occupation” disability standard that applied for the first 24 months of the plan. After the 24-month period, the plan applied an “any occupation” test for total disability, and the plan continued to find that she was disabled. But roughly a year later, the plan changed its finding, found that Cabana was no longer totally disabled, and stopped paying benefits.

Cabana retained Michael Horrow to file an action in federal court under ERISA to reinstate her LTD benefits. He marshalled the evidence of her ongoing pain and medical difficulties, and convinced the district court at trial that Cabana was, in fact, totally disabled and entitled to benefits.