Our client was just twenty six years old when he was diagnosed with a rare form of cancer. He had health insurance through his employment, but had to quit working in order to get treatment at the MD Andersen Cancer Center. Our client continued his health insurance under COBRA, and timely sent his monthly premiums to the insurance plan administrator. His employer, however, was consistently late in making premium payments for the group plan. When a sudden blizzard delayed the employer’s premium payment by just several hours, the insurance plan administrator took that opportunity to drop the whole group from the insurance plan.
This ERISA case went to a one-week trial before the federal district court in Wyoming. The federal judge found that the insurance plan administrator’s decisions were arbitrary and capricious and made in bad faith, with the intent to drop a plan beneficiary (our client) who would be making potentially high claims against the insurance trust. The judge ordered the insurance plan administrator to pay the claim. The decision was appealed to the Tenth Circuit Court of Appeals and was affirmed. The federal court ordered Wyoming Associated Builder’s Insurance Trust to pay our client’s claim for benefits and to pay our client’s attorney’s fees and costs. That case can be reviewed: Phelan vs. Wyoming Association of Builders, 574 F.3d 1250 (10th Cir. 2009)
Fraud and False Advertising
Our client purchased an individual health insurance policy advertised on television. The advertisement and the agent on the sales call promised that the insurance policy offered unlimited surgery benefits. After over one year, our client’s doctor told her to get a spinal fusion to treat her back injury. Our client and her doctor obtained pre-authorization for the surgery, but then was denied the insurance claim which exceeded $140,000.00 for hospitalization and surgery.
Jessica Rutzick & Associates, P.C. filed suit against the insurance company claiming insurance bad faith, breach of contract and fraud. In discovery we learned that this insurance company had already been fined $700,000 by the State of New York Insurance Department for false advertising, but continued its false advertising campaign across the United States. Three weeks before trial, the parties reached a seven-figure confidential settlement agreement.
Chronic Back Pain- Disability
Our client suffered from severe neck and back pain in her mid-forties, at which time she was diagnosed with C4-5 and C5-6 disc herniations. She then was in a motor vehicle collision which worsened her neck and back pain. She underwent spine surgery, but her pain continued. After a second spine surgery, her pain continued and migrated to her shoulder. She went through extensive physical therapy for several years, but that treatment did not alleviate her pain. She also had many steroid injections, which did little to help her. Our client was eventually referred to a pain clinic and was prescribed strong narcotic medication to help her manage her pain.
Our client was unable to work as a result of her neck and back pain and made a claim for disability benefits she had through her employment. Aetna Insurance paid the disability benefits for several years, but then hired a private investigator to surreptitiously surveil our client. Relying on videotapes showing our client grocery shopping, cutting hair and walking her dog, Aetna discontinued the disability benefits of nearly $3,000/month.
Jessica Rutzick & Associates, P.C. filed an ERISA appeal before the federal district court in Wyoming. The federal judge found that Aetna had arbitrarily disregarded the evidence showing that our client was disabled. The judge ordered Aetna to reinstate disability benefits, to pay the back-due disability benefits with prejudgment interest, and to pay our attorney’s fees and costs.
Trucking Collision: Interstate 80
Our client was injured when an eighteen-wheel tractor-trailer rear-ended the snowplow he was operating on Interstate 80. The collision resulted in the death of the semi driver and severely injured our client’s neck and shoulders. This case settled shortly before the scheduled 5-day trial in federal court in a six-figure settlement.
Long Term Disability Benefits
Our client owned a disability policy providing for benefits in the event of her inability to work as a dentist. The insurer, Unum, challenged its obligation under the policy in federal court. In the effort to avoid having to pay benefits, Unum improperly surveilled our client, interfered with her divorce proceedings, and inappropriately denied benefits based on unfounded allegations made by our client’s ex-husband. This “insurance bad faith” case was hotly contested and involved extensive legal briefing and argument. The case settled in our client’s favor one week before the trial was scheduled to begin. Settlement involved full payment of the value of the insurance policy, as well as a letter of apology from the insurer.
Mismanagement of Retirement Fund – ERISA
Our client, an emergency-room doctor, was a participant in a corporate retirement plan which was managed by a prominent brokerage firm. The broker assigned to the account mismanaged the retirement plan, resulting in multi-million dollar losses. A document and data-intensive case, Jessica Rutzick & Associates, P.C. prepared a well-crafted and sophisticated graphical presentation of the broker’s negligence. This compelling presentation led to a favorable (confidential) settlement in the mid six figure range, just one day before the case was scheduled for arbitration.
Vehicular Crane Wreck- South Pass Wyoming
Our client was employed as a commercial driver of an 80-ton crane. The corporation who owned the crane failed to properly maintain its brakes and our client lost control of the crane while driving down South Pass in Fremont County. He managed to avoid hitting any other vehicles on the highway, steered it off the road and jumped. Our client survived the wreck, but suffered severe injuries. After a five day trial, the jury awarded $1.8 million in damages.
This was just the third jury verdict in Fremont County over $1 million and Jessica Rutzick is the first woman plaintiff’s lawyer in Wyoming to obtain a jury verdict for a personal injury case in excess of $1 million.