ERISA & Group Ligitation

d’Arcambal Ousley & Cuyler Burk, LLP (“DO&CB”) specializes in ERISA and Group Litigation representing administrators, insurers, and plans throughout New York, New Jersey, and Pennsylvania.

Here’s what we do…

  • We obtain summary judgment on behalf of insurers in suits to recover life, health, and disability benefits under ERISA plans.
  • We successfully resolve ERISA-governed long-term disability benefits action in a cost-effective manner, frequently through mediation.
  • We partner with corporate legal departments to develop program-wide litigation readiness to ensure that the discovery process is smooth and inexpensive, and to find ways to use discovery to the company’s advantage.
  • We represent life insurers nationwide with respect to interpleaders of death benefits from large group ERISA plans.

…and here are some successful motions we’ve made:

  • New Jersey District Court dismissed plaintiff’s denial of coverage claim, holding that a company’s denial of accidental death and dismemberment benefits, was not arbitrary and capricious under the sickness exclusion.
  • Southern District of New York dismissed a provider’s claim for facility fee benefits due to failure to exhaust administrative remedies. District Court rejected provider’s motion to dismiss ERISA causes of action for unjust enrichment and equitable restitution with respect to plan administrator’s counterclaim to recover facility fees erroneously paid.
  • New Jersey District Court granted summary judgment on a disputed amount of AD&D benefits.
  • Northern District of New York dismissed plaintiff’s claim for damages under ERISA 510. District Court found that the plaintiff authorized the company to disclose information to relevant parties such as her employer. Further, District Court rejected the plaintiff’s HIPAA claim–primarily because she lacked standing to bring a private right of action against the company.
  • New Jersey District Court granted summary judgment holding that administrator was not estopped from asserting that the ERISA benefit plan participant’s son was ineligible for coverage, and that the participant was not entitled to convert dependent coverage to an individual policy retroactively.
  • Southern District of New York denied plaintiffs’ motion to remand because the provider had claimed in its State Court complaint that the patient had assigned its claims to provider and rejected the provider’s new claim that there was no assignment; the court held that ERISA pre-empted all of the state statutory and common law claims relating to claims under ERISA plans.

About d’Arcambal Ousley & Cuyler Burk LLP

For over twenty years, d’Arcambal Ousley & Cuyler Burk, LLP (DO&CB) has provided exceptional legal counsel to Fortune 500 companies and large financial institutions. For each client engagement, DO&CB emphasizes cost-effective approaches, early case assessments, and strategic planning and expertise. Our lawyers previously practiced in corporate legal departments and large law firms, so we understand the voice of the customer and its business and legal objectives. DO&CB is women-owned with offices in New York City, New Jersey and Philadelphia.

Featured Partners Handling ERISA & Group Litigation

Michelle J. d’Arcambal
Partner
Ms. d’Arcambal has handled many and varied matters relating to life, health, and disability litigation, including ERISA, since 1994. Ms. d’Arcambal has represented health insurers and recovered erroneously paid monies through litigating against providers both affirmatively and in counterclaims, including AAA arbitrations and mediations and in State and Federal Court. In particular, Ms. d’Arcambal has been on the cutting edge of health fraud matters involving waiver of co-insurance, investigational or experimental treatments, pain management claims and office-based surgery facility billing.

Jodie L. Ousley
Partner
Ms. Ousley has significant experience with fraud investigations. Ms. Ousley was instrumental in the litigation of egregious billing, unbundling, and upcoding matters. She began her legal career in New York City as an examining attorney for the Public Assistance and Grants Unit of the New York City Department of Investigation (DOI). While with DOI, Ms Ousley investigated and referred for prosecution cases of fraud, corruption, and unethical conduct.

Jaclyn DiLascio Malyk
Partner
Ms. Malyk is a seasoned litigator with experience in insurance law, including life, health, disability, insurance coverage, insurance products regulation and general contract litigation. Ms. Malyk has been extensively involved in litigating ERISA and non-ERISA disability and accidental death benefits claims, life insurance rescission actions, and disputes between providers and provider networks. Ms. Malyk provides transactional advice on state insurance and annuities regulations in connection with the development of new products and the operation of existing products, and has been instrumental in fostering program-wide proactive approaches to discovery to increase success and cost-effectiveness. Ms. Malyk graduated from Rutgers University in 1998 with a B.A., and received her J.D. from Seton Hall University School of Law in 2002.

Nada Maalouf Peters
Partner
Ms. Peters litigates in state and federal courts throughout New Jersey, New York and Pennsylvania, as well as in other jurisdictions across the country. In ERISA and non-ERISA benefits matters, Ms. Peters has achieved favorable rulings at the trial and appellate levels as well as successfully resolved matters through early negotiation and mediation. Ms. Peters also counsels clients on handling and responding to conflict discovery requests.

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NEW YORK CITY OFFICE
40 Fulton Street, Suite 1501
New York, NY 10038

Phone: 212-971-3175
Fax: 212-971-3176

NEW JERSEY OFFICE
Four Century Drive
Parsippany, NJ 07054

Phone: 973-734-3200
Fax: 973-734-3201

PHILADELPHIA OFFICE
1500 Market Street, 12th Floor, East Tower
Philadelphia, PA 19102

Phone: 215-665-5658
Fax: 215-569-8228