Pivotal Attorney McKean J. Evans Obtains Win for Employee in ERISA Disability Coverage Lawsuit

Posted Wednesday, February 27, 2019 by Pivotal Law Group

On February 27, 2019, Pivotal Law Group attorney McKean J. Evans obtained a victory in an ERISA disability lawsuit in federal District Court in Seattle. McKean's client was denied disability coverage because she filed her claim a few days late, even though the express terms of the ERISA plan permitted late disability claims as long as timely notice wasn't "practical." The employee argued timely notice wasn't practical because, at the time, she was bedridden with serious medical ailments. The Plan's claims administrator - MetLife - denied coverage claiming the employee had to prove "cognitive impairment" in order for her late claim to be accepted.

McKean filed a lawsuit on the employee's behalf under ERISA in Seattle federal court, arguing MetLife violated the ERISA plan by requiring the employee to prove "cognitive impairment" where the plan required only that timely notice not be "practical." The court ruled in the employee's favor, finding the ERISA plan allowed the employee's late claim as long as timely notice was not reasonable under the circumstances regardless of whether the employee suffered cognitive impairment. The court's ruling concluded MetLife "improperly misconstrues the plain language of the Plan to impose an additional barrier for benefits."

Pivotal Law Group attorney McKean J. Evans represents ERISA plan participants and insurance policyholders and has obtained favorable outcomes in disputes with insurance carriers in disability and other insurance disputes, including under insurance policies subject to ERISA. If you have questions regarding a disability insurance or other insurance coverage matter, contact McKean for a free consultation.