Long Term Care Insurance Claims Practices Litigation (Multiple Jurisdictions)

Eimer Stahl attorneys represented an insurer in long term care class and individual litigation over the construction of policy language written decades before care options expanded dramatically from nursing homes to a broad range of assisted-living facilities. The expanded care options were not contemplated when the policies were written. Some of this litigation was spawned by earlier, unfavorable individual coverage decisions in litigation brought prior to our involvement. In one class action, we developed a bifurcated pretrial plan to tee-up a strong class certification defense before ever reaching the merits. We thus successfully leveraged an early class settlement that will reduce claims costs over time below that which they would have been had there been no lawsuit in the first place.

  • Pavlov v. Continental Casualty Company, U.S. District Court for Northern District of Ohio (consumer class action alleging LTC carrier misconstrued policy provisions defining covered LTC facilities and Alternate Plan of Care).
  • Garat v. Continental Casualty Company, Superior Court of Alameda County, California (Section 17200 representative action alleging LTC carrier unreasonably enforced family member exclusions in policy; motion to dismiss pending).
  • Michael v. Continental Casualty Company, U.S. District Court for Northern District of California (class action alleging LTC carrier unreasonably enforced primary service requirement and refused to provide benefits under Alternate Plan of Care rider; while motion to dismiss was pending, plaintiff amended complaint and dropped class).