February 15th, 2018

Stennett & Casino filed a complaint in San Diego Federal District Court against United of Omaha Life Ins. Co. for terminating its client’s long-term disability (LTD) benefits. United of Omaha initially paid LTD benefits due to disability related to the client’s low back pain following two surgeries. Omaha, however terminated benefits after one year concluding that the surgeries had resolved client’s low back problems.

Stennett & Casino had their client undergo functional capacity testing and submitted the findings of that testing to Omaha during the administrative appeal process. The Functional Capacity Evaluation (FCE) found that the client had a maximum sitting tolerance of approximately twenty-seven (27) minutes and a standing tolerance of between two (2) and ten (10) minutes. Omaha had its physician, Dr. Neuren, review medical records including the FCE. Dr. Neuren dismissed the FCE as merely a restatement of subjective complaints and concluded that there was a “lack of support” for ongoing impairment.

United also sent a letter to the client’s treating surgeon asking him to agree with its assessment that although the client had some ongoing limitations due to his back condition, he was able to return to his prior occupation. The surgeon signed the document and returned it to United indicating his agreement.

Prior to the trial, Stennett & Casino contacted the surgeon and provided him with a copy of the FCE and a description of the client’s job duties, which he had never previously seen. After reviewing the FCE he provided a statement in which he deferred to the FCE findings of disability describing it as “thorough in its testing and evaluation of functionality.”

The District Court found that Stennett & Casino had met their burden of proving that their client was disabled under the plan commenting that Omaha’s physician and nurse’s paper reviews, which included no examination, observation or discussion with the client were less persuasive than the information provided by Stennett & Casino from the treating physicians and FCE. The court ordered payment of all LTD benefits to the client. The court’s opinion can be found at Fritch v. United of Omaha Life Ins. Co., 2017 U.S. Dist. Lexis 201141.

June 2nd, 2017

Most disability policies have a two-year limitation on benefits for disabilities caused by a mental illness or disorder. Thus if the cause of your disability is depression, you will be limited to 24 months of disability benefits. We are now seeing more policies that expands the mental illness limitation to those disability caused or contributed to by a mental illness or disorder. This type of limitation, applied in the extreme, could result in limiting to 2 years the benefits payable on virtually all disabilities. The following case is an example of Reliance Standard Insurance Company’s attempt to expand the application of this limitation.

Our client came to us after having been paid disability benefits for 5 years by Reliance Standard due to a back injury. The doctors were unsuccessful in treating her condition which left her in constant pain. As a result she developed what was diagnosed as a Chronic Pain Syndrome with symptoms of depression and anxiety. This resulted in Reliance Standard terminating her disability benefits claiming that her disability was contributed to by a mental disorder – depression and anxiety.

Stennett & Casino had to file suit and go to trial on behalf of our client on this issue. We were successful in convincing the court that 1) the client’s back pain was the cause of her depression; 2) the disability policy was ambiguous, and; 3) that the mental illness limitation did not apply to mental conditions arising from a physical disability.  Our client received a judgement for the payment of all back benefits owed and entitlement to future disability benefits. The court’s opinion can be found at Jarillo v. Reliance Standard Life Insurance Co., 2017 U.S. Dist. Lexis 59928.

May 10th, 2016

We are seeing more and more claims for Accidental Death benefits denied under an exclusion for “loss” caused by “illness or the treatment thereof.” Whenever an insured involved in an accident is taking prescription medication, the insurer argues that the accident was, in part, caused by the medication side effects. Likewise, when an insured has an illness that weakens his/her ability to recover from a physical trauma, the insurer argues that the illness contributes to the death and thus is excluded under the policy.


These arguments taken to their extreme would result in almost all Accidental Death Claims being denied unless the insured was in absolutely perfect health at the time of his/her accidental death. Stennett & Casino have been able to overcome these defenses in multiple ways depending on the specific facts and policy involved.


As an example we recently had a young woman contact us whose husband died after falling in the kitchen and hitting his head resulting in a skull fracture and subdural hematoma. MetLife denied her claim for Accidental Death benefits under the “illness exclusion” because the death certificate indicated that a contributing cause of death was a “seizure disorder.” The claim was that her husband fell because of a seizure. However, a close review of the medical records reflected that her husband did not suffer from a seizure disorder but rather experienced a seizure after hitting his head. Additionally, even if his fall had been caused by a seizure, the seizure was not the cause of death. The cause of death was the skull fracture and subdural hematoma.


Stennett & Casino convinced MetLife to pay the full amount of policy benefits plus interest without having to file suit.


May 6th, 2016

Our client was a 64 year old second grade bi-lingual teacher who fell hitting her forehead into a concrete wall. She immediately lost consciousness but believed she was okay.  Over the next several days her family noticed that she was incoherent so she did not return to work but had a substitute teacher cover her classes.

She filed a claim for disability benefits with Standard Insurance Company. They paid her benefits for a year and a half when her benefirs were terminated.  She hired Stennett & Casino to handle her appeal.

It was obvious to us that our client suffered a traumatic brain injury. In order to prove her disability we had her undergo neuropsychological testing. The testing supported her injury.

Stennett & Casino submitted the testing as part of her appeal.  As a result Standard Insurance reopened her claim and paid the benefits owed her under her disability policy.

May 6th, 2016

Our client’s daughter died while she was an inpatient at a drug rehabilitation center due to the toxic effect of combining prescriptions for an anti-depressant with methadone which were both administered by the facility. The treating physicians should never have combined these 2 medications since they have a known toxic reaction.

The father’s claim for benefits under his accidental death policy with Life Insurance Company of North America (LINA) however was denied under an exclusion for death resulting from an illness or the treatment thereof. The father lived in Palmdale California and found the Law Offices of Stennett & Casino through a web search. Since we had handled several cases with similar issues he felt we were the right fit for his claim against the insurance carrier.

After filing an administrative appeal on the father’s behalf and then filing suit in the Los Angeles Federal District Court LINA (a subsidiary of CIGNA) continued to deny coverage. It wasn’t until Stennett & Casino filed a motion for judgment asking the court to confirm our interpretation of the policy that the insurer finally relented and paid under the policy.

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