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The Pivotal Law Blog

Washington State Insurance Commissioner Fines United Healthcare for Denying Women's Health Claims

Posted Thursday, October 18, 2018 by Pivotal Law Group

On September 13, 2018, Washington's Insurance Commissioner entered into a Consent Order with United Healthcare regarding violations of Washington insurance law governing women's health claims. United Healthcare is a health care service contractor that…

ERISA Plan Administrator Cannot Unilaterally Ignore Treating Physicians, Appeals Court Confirms

Posted Thursday, October 11, 2018 by Pivotal Law Group

A recent appeals court ruling emphasizes that ERISA plan administrators cannot ignore the opinions of a claimant’s treating physicians absent tangible evidence those opinions are wrong. In Hennen v. Metropolitan Life Insurance Company, the appellate…

ERISA Guide by Pivotal Attorney McKean Evans Published in WSAJ Trial News

Posted Wednesday, October 10, 2018 by Pivotal Law Group

Attorney McKean J. Evans published a guide to handling insurance claims under the Employee Retirement Income Security Act ("ERISA") in the October edition of the Washington State Association for Justice Trial News.

Seattle's Domestic Workers Bill of Rights

Posted Tuesday, September 25, 2018 by Pivotal Law Group

Are domestic workers like nannies, gardeners and housekeepers entitled to basic worker protections like breaks and minimum wages? The answer used to be no, but under Seattle’s new Domestic Worker Bill of Rights, domestic workers have new and important…

Inverse Condemnation Claims – Sound Transit

Posted Thursday, September 20, 2018 by Christopher L. Thayer

Division II of the Washington Court of Appeals recently addressed a situation where a landowner asserted an inverse condemnation claim against Sound Transit and the City of Tacoma for flood damage which plaintiff claimed was caused by the negligence of…

The Importance of Planning for Medical and End-of-Life Decisions

Posted Wednesday, September 12, 2018 by Pivotal Law Group

People make an estate plan because they want certainty about what will happen in the future. This often includes certainty about who will make medical decisions for you if you’re ever unable to do so. For many people, one important future medical…

Five Important Things You Should Have in Your LLC Operating Agreement

Posted Wednesday, September 5, 2018 by Kim Sandher

While most states don’t require you to have an operating agreement (Washington is the one of the states that does not require it), one of the biggest mistakes people make after setting up a Limited Liability Company is not drafting an operating…

Title Insurance Cover Tribal Fishing Rights Claims Against Landowner Says Court of Appeals

Posted Thursday, August 30, 2018 by Pivotal Law Group

Title insurance is a critical part of most real estate deals. In Washington and throughout the U.S., a piece of real estate has likely changed hands numerous times, including typical purchase money mortgage sales, foreclosures, bequests via a will or…

The Brave New World of Cybercrime Insurance Coverage Disputes

Posted Monday, August 27, 2018 by Pivotal Law Group

Computer crime and data breaches have become a reality for most businesses. Words like spearphshing or ransomware that were obscure five years ago are now in the headlines on a regular basis. The FBI calculated over $1.4 billion in reported losses from…

Court of Appeals Reiterates Insurer’s Obligation to Protect Policyholder From Lawsuit

Posted Thursday, August 16, 2018 by Pivotal Law Group

When a driver crashes into another vehicle and is sued for damages, the driver's insurer typically has an obligation to defend the lawsuit and act in good faith to protect its insured's interests. When the insurer fails to do so, the driver likely has…

Washington Updates “Mandatory” Arbitration Statute

Posted Wednesday, July 18, 2018 by Christopher L. Thayer

In Washington, civil cases involving claims less than $50,000, which are filed in Superior Court, are referred into the court-sponsored “mandatory” arbitration program. Under this process, an attorney with at least five years of experience is appointed…

Health Insurer Fined For Violating Independent Review Rules

Posted Wednesday, July 11, 2018 by Pivotal Law Group

Washington's insurance commissioner recently announced a $100,000 fine in response to a consumer complaint that Kaiser Foundation Health Plan, an HMO, ignored consumers' rights in the health claims appeal process. The commissioner found that Kaiser…

Case law update: The “self-service” exception for a Slip and Fall injury at a Grocery Store

Posted Friday, July 6, 2018 by Christopher L. Thayer

In a December 2017 decision, the Washington State Court of Appeals, Division III, addressed a slip and fall personal injury claim where claimant fell in the shampoo aisle of a Walmart in Sunnyside. In McPherson v. Wal-Mart Stores, Inc., No. 34696-0-III…

Pet Insurance: Read The Fine Print

Posted Thursday, June 28, 2018 by Pivotal Law Group

Great Danes might be the best dogs - they're calm, require relatively little exercise and space, and are super affectionate towards their human family. Unlike a lot of needier breeds who need constant activity, Danes reputedly just want to chill with you…

The Importance of Addressing Digital Assets in Estate Planning

Posted Wednesday, June 20, 2018 by Pivotal Law Group

More than ever, technology is fundamental to our lives. In 2018, even hardened luddites maintain email, social media, and/or cloud-storage accounts, or store considerable information on their smartphones. Maintaining digital information electronically…

Health Plans Can’t Discriminate Against Mental Health Treatment Says Ninth Circuit

Posted Thursday, June 14, 2018 by Pivotal Law Group

Among the challenges of a mental health condition is the difficulty persuading health insurers to cover treatment. Mental health conditions can be difficult to objectively diagnose and can require lengthy and expensive treatment often with little…

Insurance Dispute Timing

Posted Tuesday, June 12, 2018 by Pivotal Law Group

How Long Do I Have To Dispute An Insurance Claim?* If your insurer denies your claim or takes some action with which you disagree, how long do you have to dispute the insurer’s decision? For example, if your health insurer refuses to authorize surgery…

Washington Supreme Court Strikes Down “Maximum Medical Improvement” Limits in Auto Policy Coverage

Posted Tuesday, June 12, 2018 by Pivotal Law Group

On June 7, 2018, the Washington Supreme Court, in Durant v. State Farm, ruled insurers may not limit payments to policyholders under auto insurance Personal Injury Protection (“PIP”) to only treatment needed for the insured to reach “maximum medical…

Washington Court of Appeals Emphasizes Insurers May Not Categorically Ignore Their Insureds’ Treating Physicians

Posted Tuesday, May 22, 2018 by Pivotal Law Group

Shannon Leahy found herself in a common situation when dealing with her auto insurer following a car crash. Her insurer agreed she was not at fault, but refused to pay her claim, arguing her medical treatment was unrelated to the crash. Ms. Leahy’s…

Case Law Update: Recreational Use Immunity Act Clarified

Posted Wednesday, May 16, 2018 by Christopher L. Thayer

In Lockner v. Pierce County (No. 94643-4, April 19, 2018), the Washington Supreme Court recently revisited Washington’s Recreational Use Immunity Act and clarified its application. RCW 4.24.210 provides protection for owners of recreational property…

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