Ninth Circuit Reverses District Court’s Determination that Claimant Waived Life Insurance Waiver of Premium Claim

If you have a claim for long-term disability benefits under an employer-provided plan governed by the Employee Retirement Income Security Act (“ERISA”), it is possible that you may qualify or have a life insurance waiver of premium claim (“LWOP”). An LWOP claim enables you to keep, at no cost, your employer-provided life insurance coverage while you are disabled, usually to age 65. Often, employees are not aware of the LWOP benefit and do not apply for it. Sometimes, if an employee has an active long-term disability claim, an LWOP claim will be automatically opened for them if the insurance company insures both the long-term disability and life insurance plans. It is important to request all benefit plan information from your employer to determine whether you can receive both benefits and which entitles will handle your claims. If an insurance company denies both your long-term disability and LWOP claims, it will be important to clearly allege both benefits in your lawsuit complaint so there are no procedural hurdles to obtaining full relief.

In Mrkonjic v. Delta Family-Care And Survivorship Plan, No. 19-56059, __F.App’x__, 2021 WL 2071973 (9th Cir. May 24, 2021), Plaintiff-Appellant Mrkonjic appealed the district court’s determination that he waived his claim for a life insurance premium waiver. The court found the district court erred because it ordered relief on Plaintiff’s Count One claim, which included the life insurance premium waiver. The claim was not precluded by the rule of mandate from the Ninth Circuit’s prior ruling in the parties’ second dispute that dealt only with his claim for long-term disability benefits. The court explained, “The premium waiver is part and parcel of his claim for wrongful denial of long-term disability benefits, and it flows directly from the rescission of his early retirement decision. The district court should consider whether Mrkonjic is entitled to the premium waiver under the Mrkonjic I judgment, along with any related claim preclusion considerations, on remand.”

If you have a denied long-term disability or life insurance claim, contact us for a complimentary case evaluation. We have helped hundreds of clients over the years establish their entitlement to benefits.