Life, Health, Disability, and ERISA

At Goldberg Segalla, we aggressively defend insurers and plan administrators in state and federal courts throughout the United States. As part of our Best Practices philosophy our attorneys maintain comprehensive knowledge of the complexities that frequently arise in life, health and disability benefits litigation. We understand that decisions in one jurisdiction or Federal Circuit are likely to have a spillover effect into other venues. Staying abreast allows us to offer critical guidance for plan and claim administrators with multiple similar claims in different jurisdictions.

Life Insurance

Our attorneys have experience with all life insurance issues. Some recent claims include:

  • Whether a death was “accidental”
  • Contestability, fraud and material misrepresentation (including foreign death schemes)
  • Policy cancellation issues
  • Unique beneficiary issues

Health Insurance

In order to help clients achieve the best possible outcome, we focus on the details of each case while also keeping an eye on the big picture. Recently, we have successfully handled health insurance matters including:

  • Disputes over payor submissions deadlines and third-party billing
  • Health insurance and provider audits
  • HIPAA compliance issues and litigation
  • Healthcare subrogation and third-party lien disputes
  • Billing agent errors and omissions
  • Mandatory insurance reporting to CMS

Disability

We know that results matter. Our recent achievements include:

  • Successfully defeating challenges to discretionary clause language
  • A determination that benefits are limited to an “own occupation” period as opposed to “any occupation”
  • Resolving disputes among overlapping disability policies
  • Litigation over a plan conflict of interest affecting the standard of review
  • Limiting discovery to the administrative record

Employee Retirement and Income Security Act (ERISA)

Our attorneys have a heightened appreciation of the nuances associated with defending employee benefits claims under ERISA, and are adept at counseling clients on issues arising from overlay of this Act. At Goldberg Segalla, we focus on:

  • Proactive and prompt removal of ERISA cases to the federal courts
  • Evolving issues concerning ERISA preemption, including preventing claims of estoppel, waiver, bad faith, fraud, etc.
  • Ensuring the proper confines of discovery, including limitation to the administrative record and limitation of discovery against an insurer or carrier regarding its claims process
  • Aggressive motion practice to dismiss common law claims and preclude experts

Leaders in Life, Health, Disability, and ERISA Practice

Goldberg Segalla attorneys are nationally recognized leaders and authorities in the field of life, health, disability, and ERISA. A small sampling of highlights includes:

  • Goldberg Segalla is included on Res Loquitor’s “Select List” of law firms for the defense of life, health, and disability matters.
  • Richard J. Cohen and Daniel W. Gerber authored the chapter on life insurance for the seminal New Appleman on Insurance Practice Guide.
  • The chapter on life insurance fraud in the life, health, and disability installment of Appleman on Insurance 3d, with an expanded section on stranger-originated life insurance (STOLI), was authored by our team of Dan Gerber, Anthony J. Golowski II, Fallyn B. Cavalieri, and Clayton D. Waterman.
  • Dan Gerber is immediate-past Chair of the Defense Research Institute’s Life, Health, and Disability Committee. In 2010, he received DRI’s Al Parnell Award for Best Seminar Chair for the Life, Health, Disability, and ERISA seminar.
  • Dan also serves on the Life Insurance Committee of the International Claim Association and is a regular speaker on this topic at the ICA’s Annual Meeting.
  • Sarah J. Delaney is the Online Community Chair, and a past Annual Meeting Chair, for DRI’s Life, Health, and Disability Committee.
  • Anthony Golowski on the ICA’s Fraud and Claim Abuse Committee. He and Sharon Angelino spoke on "Proactive Insurance Fraud Investigations” at the ICA’s Annual Education Conference in 2011.
  • Joanna M. Roberto and Paul C. Steck authored “Investing in Death Creates Judicial and Regulatory Issues” on STOLI transactions for DRI’s For the Defense.

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Diversity

Leadership and Action

To put our philosophy and commitment into practice, we have a Diversity Task Force, which includes our Managing Partner, in place to conceptualize and implement diversity-focused programs as well as give diversity a voice in our decision-making at the highest level. The individuals on this task force share the firm’s strong commitment to increasing the diversity, and they use their unique experiences and backgrounds to support and advance that goal. The team meets regularly to create programs, schedule events, establish diversity initiatives both inside and outside of the firm, set long-term goals, and develop the strategy to recruit and retain people from diverse backgrounds.

The Chair of our Diversity Task Force, Joseph M. Hanna, has spearheaded numerous diversity initiatives in various organizations and outreach programs, serves on several diversity-related committees, and is a frequent author and speaker on diversity. Among other positions, he is Chair of the American Bar Association (ABA) Minority Trial Lawyer Committee and its Special Committee on Human Rights, Editor-in-Chief of the ABA’sMinority Trial Lawyer, a 2014 Fellow of the Leadership Council on Legal Diversity (LCLD), a past President of the Minority Bar Association of Western New York (MBAWNY), current President of the MBAWNY Foundation, and the Diversity Liaison for several committees at the 22,000-member Defense Research Institute (DRI).

Each summer, Goldberg Segalla proudly welcomes interns through a formal Diversity Clerkship Program that was conceived by Joe while he served as President of the MBAWNY. The program was developed in collaboration with the MBAWNY and the SUNY Buffalo Law School to provide opportunities for minority UB Law students to gain firsthand experience in the legal system. Since it was launched in 2011, the program has placed more than 80 students in clerkships in area courts as well as in several area law firms, with more judges and law firms asking to participate every day. It provides participants with an in-depth look at the legal process and the interaction between the bench and the bar that they would not otherwise get. At our firm, a dedicated team of partners monitors the work of these law clerks and ensures they obtain valuable experience to help develop important legal research, writing, case management, and client service skills critical to their long-term success. Our program earned the firm the Minority Corporate Counsel Association’s 2012 George B. Vashon Innovator Award.

We also have sponsored Success in the City, an annual diversity networking and mentoring event developed by Joe that brought together students, legal and business professionals, educators, nonprofits, and political leaders to make lasting partnerships. Many employment, business, and mentoring relationships resulted from this event. Past events have drawn more than 500 political and business leaders, legal professionals, and students. Success in the City has influenced the development of similar programs in Baltimore, Cleveland, Birmingham, Dallas, and elsewhere.

Goldberg Segalla also demonstrates leadership inside our firm and throughout the legal community specifically focused on the advancement of women. As a complement to our Diversity Task Force, we have developed a formal Women’s Initiative — a firm-wide movement designed to spark opportunities, develop mentoring relationships, promote leadership, plan events, and support the advancement of women in legal, management, and administrative contexts.

Our firm is committed to spreading the message throughout the broad legal and business communities that embracing diversity contributes to greater overall success. We conduct training sessions for in-house counsel at Fortune 500 corporations on increasing and promoting diversity.  Our attorneys have authored articles and delivered presentations on diversity for various legal organizations, including the Defense Research Institute and the American Bar Association, and our efforts and accomplishments in this area have been profiled in publications such as Law360, the New York State Bar Association’s State Bar NewsBusiness First of Buffalo, the Buffalo Law Journal, and others.

In one recent example of our work to provide inspiration and raise awareness of diversity and women’s issues in the legal community, Caroline Berdzik, a partner in our Princeton office and a member of our Women’s Initiative Leadership Committee, spoke to Law360 for the publication’s “Female Powerbrokers” series. In the interview, Caroline discussed her career, the challenges of being a woman at a senior level at a law firm, the work-family life balance, and the importance of taking risks. She also offered guidance to female attorneys on moving their careers forward and advice to law firms on both increasing the number of women partners and retaining top female talent. Her longtime advocacy for women (at her previous firm, she served on the Women’s Business Development Committee and was a member of what became the national Women’s Presidents Organization) helped earn her a spot on the 2015 NJBIZ list of New Jersey’s Best 50 Women in Business.

Joe Hanna also was featured by Law360 in its “Minority Powerbrokers” series, in which he shared his perspective on breaking the glass ceiling in the legal industry, the challenges of being a lawyer of color at a senior level, how law firms can increase diversity in their partner ranks, and Goldberg Segalla’s core commitment to diversity.

Partnerships

Goldberg Segalla is proud to be a member of the Minority Corporate Counsel Association Firm Affiliate Network, which was created by the MCCA to assist and acknowledge law firms that are committed to advancing diversity and inclusion in the legal profession.

We are also a member of the Leadership Council on Legal Diversity (LCLD), a national organization of leaders in law firms and corporate legal departments dedicated to creating a truly diverse legal profession. As noted earlier, Joe Hanna was a Fellow of the LCLD in 2014. In this position, he played a critical role in organizing the first-ever New York City LCLD Fellows Roundtable event, and he was instrumental in establishing a mentorship program in Hartford for local diverse first-year law students.

We support the diversity efforts of numerous organizations, including:

  • American Bar Association
  • Asian American Bar Association of New York
  • Columbian Lawyers Association
  • Defense Research Institute
  • Federal Bar Association
  • Korean American Association of Greater New York
  • League of First Nations
  • Minority Bar Association of Western New York
  • National Bar Association
  • Native American Rights Fund
  • National Association of Asian American Professionals
  • National Congress of American Indians
  • New York State Bar Association
  • Seneca Free Trade Association
  • SUNY Buffalo Law School
  • Women’s Bar Association of the State of New York

Our outreach efforts led to the creation of a comprehensive database of more than 500 minority law organizations throughout the United States. Contact between these organizations takes place in anticipation of bringing CLE and legal programs together. This group of minority bar associations includes both local and national organizations, such as:

  • National Association of Women Lawyers
  • National Association of Muslim Lawyers
  • Hispanic National Bar Association
  • National Asian Pacific American Bar
  • Black Women Lawyers Association of Los Angeles
  • South Asian Bar Association of Philadelphia
  • Vietnamese American Bar Association of North Carolina
A Talented and Diverse Team

Diversity is further evident within our firm through the many languages and dialects our team speaks, including Arabic, Croatian, French, German, Greek, Hebrew, Hindi, Italian, Korean, Malayalam, Mandarin, Marathi, Norwegian, Portuguese, Punjabi, Russian, Spanish, Swedish, Tagalog, Tamil, Thai, and Urdu.

Goldberg Segalla’s culture is one that values team-spiritedness, collegiality, and interpersonal harmony within our working community. We are a firm that believes in diversity in the workplace, and we are proud to offer a professional and positive work environment for each and every member of our team.

On these values, and on our commitment to diversity, we will never waver. We are proud of what we have accomplished thus far, but we also realize that this is a long-term mission. We will continue to innovate and to improve diversity in law and business — both within Goldberg Segalla and across the communities in which we live and work.

Diversity Matters — Join the Conversation

If you have questions regarding any of the firm’s diversity initiatives or would like to discuss ideas regarding increasing diversity in the legal profession, please contact Joe Hanna (716.566.5447;[email protected]) or another member of our Diversity Task Force: