Baker Sterchi Member David Eisenberg is quoted in a recent St. Louis Record article “Federal judge dismisses widow of heroin addict's lawsuit over vague insurer plan language, no appeal of insurer's denial” regarding the dismissal without prejudice of a matter in which accidental death benefits were denied by the defendant insurer because the death was deemed an intentionally self-inflicted injury. The court held that the plaintiff was obligated to exhaust the insurer's internal appeal procedure before heading to court, even though (1) the appeal procedure was described in the denial of benefits letter sent to plaintiff but not in the benefit plan document itself, and (2) the letter did not warn Plaintiff that failure to utilize the procedure could prevent Plaintiff from filing in court.
Eisenberg notes the case is “interesting procedurally, because it drives home some of the issues involving exhaustion of administrative remedies” and adds that given the court's decision to dismiss the case without prejudice, “plaintiff may have another shot through the appeals process” if the case does not settle out of court.
Eisenberg has over thirty years of experience representing Fortune 100 and other companies in employment and labor law matters, consumer and general business litigation, and appellate litigation. He is the Editor of Baker Sterchi’s Missouri, Employment & Labor, and Product Liability blogs and has served on the Editorial Board of the ABA Appellate Practice Committee, and on that Committee’s Appellate Rules subcommittee.The St. Louis Record, a publication of the U.S. Chamber Institute for Legal Reform, covers the legal system, focusing on civil actions in the St. Louis area.
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