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Timothy M. Garvey's Legal Cases (4)

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Employee benefits

ERISA Disability Case

Jan 15, 2019

OUTCOME: Judge reversed his prior decision and ruled for our client

On January 15, 2019, the attorneys at McDermott Law succeeded in having a federal court judge reinstate our client’s long-term disability benefits after a five year fight. This case was significant f ... or several reasons. This client came to us for help years after his insurance company terminated his benefits. In fact, the insurance company terminated the client’s benefits in 2013, at which point he hired another law firm to assist him with an internal appeal. Unfortunately, that was unsuccessful and the client was forced to sue in 2015. By the time the client was referred to us by his former attorney, the case had already been submitted to the judge and the client was simply waiting for the judge to enter his ruling. A month after the client came to us, the judge ruled against the client and for the insurance company, finding that (under the abuse of discretion standard), the insurance company’s decision to terminate the client’s benefits was reasonable. The judge then dismissed the client’s case. That’s when the attorneys at McDermott Law went to work. Analyzing the judge’s decision, McDermott Law attorneys Shawn McDermott and Timothy Garvey, realized the judge made a mistake when he applied the abuse of discretion standard, which made him reach the wrong decision. So, the attorneys at McDermott Law sprung into action and asked the judge to reconsider his order. For obvious reasons, judges rarely agree to do so, but McDermott Law believed asking anyway was the right thing to do and could potentially save the client another years-long battle in the court of appeals. Just three months after the attorneys at McDermott Law took over and asked the judge to reconsider his order, he agreed to do so. Even more surprisingly, the judge reversed his prior decision and entered judgment in our client’s favor, ordering the insurance company to pay the client’s disability benefits from December 4, 2013 and continuing until he reaches age 65. Better yet, the judge awarded our client his costs and instructed McDermott Law to file a motion for interest and attorneys’ fees. In taking the extraordinary step of reversing his prior decision, the judge repeatedly referred to the advocacy presented by McDermott Law, which compelled him to reverse his decision and rule in our client’s favor.

Insurance

AD&D insurance claim

Oct 24, 2018

OUTCOME: Settled for nearly twice the policy limits

I recently helped a client settle a dispute with her insurer over a denied accidental death and dismemberment (“AD&D”) claim. While the amount of the settlement is confidential, it was a six-figure set ... tlement that was nearly twice the amount the insurer would have owed had it simply done the right thing from the outset and paid the claim. In this case, I represented the widow of a man who died tragically in a boating accident. Years before his death, our client’s husband purchased an AD&D insurance policy to protect his family if he ever died a sudden and traumatic death. However, when the time came for the insurer to make good on the promises it made in the policy, it chose to protect its money instead of keeping its promise to protect his family and denied the widow’s claim. Initially, this client hired another lawyer to assist her in appealing the insurance company’s denial, but when that proved unsuccessful, the client and her attorneys retained us for our expert knowledge regarding AD&D claims (and insurance law, generally). Winning this case was not easy, because an autopsy revealed the client’s husband had a BAC of 0.119 when the accident happened. And, based on this fact, the insurer denied the client’s claim, asserting that the policy did not cover losses caused or resulting from the insured’s intoxication. However, once we were retained, we closely scrutinized the AD&D policy and realized the insurance company intentionally misrepresented the policy’s exclusion when it told our client that her husband’s death was not covered. Realizing the insurer’s mistake, we sued the insurance company, asserting claims for breach of contract, bad faith breach of an insurance contract, and violation of C.R.S. §§ 10-3-1115 and -1116. We leveraged the law and asked the court to rule in our client’s favor as a matter of law (by filing a motion for summary judgment) and to allow her to pursue a claim for punitive damages against the insurance company (by filing a motion for punitive damages). Concerned for how much it would have to pay if it lost these motions, the insurance quickly started talking settlement. Ultimately, our advocacy caused the insurance company to pay our client nearly twice the amount it would have owed had it just done the right thing from the start and paid the claim. At McDermott Law, we understand how overwhelming it can be to fight insurance companies on your own—especially in times of tragedy—and we’re always ready to help. So, if you need help with a denied AD&D claim—or any other insurance dispute—do what other attorneys do when they need help: contact the attorneys at McDermott Law.

Employee benefits

Successful ERISA Disability Outcome

Sep 27, 2018

OUTCOME: Settled favorably after defeating the insurance company's attempt to dismiss a claim under ERISA 502(a)(3).

The insurance company cut-off our client's disability benefits for no good reason. We assisted our client in appealing the decision, but the insurance company continued its bad behavior and we had to s ... ue. We sued the insurance company to recover the benefits owed to our client, plus a claim seeking "other appropriate equitable relief" under ERISA 502(a)(3). The insurance company then asked the court to dismiss the claim for other equitable relief. However, the court sided with our position and denied the insurance company's request. The case settled favorable soon afterwards. 2018 WL 4635983 (D. Colo. Sept. 27, 2018) (survived insurer’s attempt to dismiss Plaintiff’s claim seeking equitable relief under ERISA 502(a)(3))

Life insurance

Life Insurance Case

Jun 04, 2018

OUTCOME: The Colorado Supreme Court agreed with our position

The facts of this case were particularly tragic: “[w]hile appearing to be in a ‘zombie-like’ state from a combination of prescription medication, alcohol, and marijuana, Mark Renfandt shot himself in t ... he head and died.” Id. at ¶ 1. “When Mark’s wife tried to collect life insurance benefits under a temporary coverage agreement issued by New York Life Insurance Company, the insurer denied the claim, citing a provision in the agreement that excluded coverage for ‘suicide … while sane or insane.’” Id. Mark’s wife then sued New York Life, claiming that by denying her claim for benefits it breached the contract and that it did so knowingly and in bad faith. We assisted with a brief to the Colorado Supreme Court, arguing “the general rule in Colorado is that suicide is no defense for nonpayment of life insurance benefits. However—to protect insurance companies against fraud by insureds—Colorado permits life insurance companies to exclude coverage for suicides within the policy’s first year. But, when an insured’s self-killing is unintentional, the concerns of fraud dissipate, as do the public policy reasons supporting this limited exception.” Echoing our arguments, the Colorado Supreme Court (ruling in favor of Mark’s wife) stated that suicide exclusions “protect insurers from a ‘risk’ that lies wholly in the control of the insured. To apply the exclusion to an individual who lacks suicidal intent is inconsistent with the purpose of such provisions.” Renfandt, 2018 CO 49 at ¶ 51 (citation omitted). Thus, the Colorado Supreme Court concluded, “in Colorado, a policy exclusion for ‘suicide … while sane or insane’ still requires an insurer to show that the insured’s death was a ‘suicide.’” Id. at ¶ 52. And, that’s exactly the result McDermott Law advocated for in its amicus brief.