Life, Annuities, Health, and Disability Products and Plan Litigation

DO&CB specializes in nationwide individual life and disability product litigation with an emphasis in New York, New Jersey, and Pennsylvania. With a deep understanding of life insurance companies gained from serving as both inside and outside counsel for over 25 years, we proactively represent our clients in a variety of actions including:

• Rescission actions.
• Interpleader matters
• Lapse actions.
• Sales practice matters.
• Stranger-Owned Life Insurance (STOLI).
• Life and disability claim litigation, including suicide exclusions and disability waiver of premium riders.
• Representative Matters

…and here are examples of DO&CB’s successes:

• Obtained judicial rescissions of life insurance policies based on material misrepresentations through motion, trial and/or appeal
  • New York appellate victory holding that insurer must have actual, not constructive, knowledge of misrepresentation during underwriting. New York Court of Appeals denied a motion for leave to appeal based on alleged post claim underwriting.
  • Third Circuit Court of Appeals victory affirming summary judgment rescinding a
    $1,000,000 policy based upon material misrepresentations where plaintiff ’s primary argument was that the insured did not understand the English language.
  • New York County trial court granting partial summary judgment finding that the inability to understand the English language was not a defense and dismissing extra- contractual damages claims. Court directed that the rescission case be heard by the court, not a jury, and the court rendered judgment in the insurer’s favor after trial.
  • New Jersey Superior Court granting summary judgment rescinding a life insurance policy based upon health misrepresentations, holding that where the applicant complained to his doctor of chest pain and the applicant’s physician diagnosed applicant with a shoulder injury, applicant’s negative response to a question pertaining to whether the applicant sought treatment for chest pain was a material misrepresentation.
  • New Jersey Appellate victory affirming rescission of life policy based on material financial misrepresentations.Trial and appellate courts rejected claim that tax returns did not reflect earnings, and that misrepresentation as to existing other insurance was not material.

• Successfully litigated breach of contract claims involving lapsed policies, suicide exclusions, foreign death claims and fraudulent schemes including:
  • New York Appellate Division affirming trial court holding that insurer had six years to rescind policy under the New Jersey Fraud Prevention Act based on a speculative policy scheme.Trial Court also found that the premium payer misrepresentations were contrary to anti-money laundering and Patriot Act requirements.
  • Successfully resolved several litigations regarding the applicability of the suicide exclusion based on New York, Connecticut and New Jersey presumptions after third party subpoena discovery.
  • New York Appellate Division affirming trial court dismissal of complaint seeking benefits under a lapsed policy, rejecting beneficiary’s claim that the grace period to pay premiums was extended by agent, who did not have the authority to extend the grace period.
  • Successfully litigated lapse cases alleging improper notice of lapse, based on expiration of limitations period set forth in lapse statutes.
  • Successfully litigated foreign death claims, including in the interpleader context.

• Successfully litigated varied individual disability claims including,
  • Successes include cases involving limitation of liability on disability policies concerning disputes regarding interpretation of contractual terms, billing codes and medical conditions.
  • Decision to rescind a disability policy after the two-year contestability period based on factual determinations that the insured acted with fraudulent intent and that misrepresentations continued in trial testimony.
  • Successes include resolving numerous claims for individual disability benefits after discovery, including social media.
  • Successes include New York Supreme Court dismissal of multimillion-dollar disability waiver of premium claim and resolution of disability waiver of premium claim where there were allegations of misrepresentation by customer service.
  • Successes include resolution of New York trial court disability action where plaintiff attempted to extend coverage of the disability policy covering “outpatient surgery,” to include certain types of non-covered injections.

• Successfully litigated matters involving the agent/ sales representative.
  • New York Appellate Division affirming summary judgment holding that an agent has no fiduciary duty to a beneficiary of a life insurance policy.
  • New York County trial court dismissing action brought by an investor alleging sales representative committed fraud in connection with variable life and annuities products.
  • Eastern District of New York granting summary judgment rescinding a life insurance policy based on financial misrepresentations, holding that an insurer is not estopped based on an agent’s knowledge of the misrepresentation.
  • New York County trial court granting summary judgment rescinding a life insurance policy, finding that the agent’s alleged knowledge of a material misrepresentation cannot be imputed to the company. , as the insurer “could not be held responsible for
    … knowledge of an unfaithful employee.”
  • New York County trial court granting summary judgment rescinding a life insurance policy, finding that the insured’s misrepresentation in the application for insurance concerning his annual earned income was material and unambiguous.

Back