Published Decisions

Noteworthy Court Opinions For Bonny G. Rafel, LLC Litigated Cases

Ms. Rafel provides court opinions for some of her litigated cases. These opinions can be easily downloaded from this list.

Court of Appeals Sets Bonny G. Rafel's Hourly Rate Insurance Companies Must Pay

Stevens v. Santandar Holdings, USA, Inc. Sel, Liberty Life Assurance Co. of Boston, et.al, CV 14-1481 (Oct. 21, 2015).

On May 20, 2015 the Third Circuit Court of Appeals heard oral argument in one of our cases, and after denying Liberty's appeal for lack of jurisdiction, ordered that the insurance company, Liberty, pay all of our legal fees associated with the Third Circuit Appeal. The Third Circuit determined that the hourly rate for counsel, Mark Debofsky, Esq. counsel from Chicago, Illinois should be $600.00 per hour and the hourly rate for counsel, Bonny G. Rafel, Esq. counsel from Florham Park, New Jersey should be $500.00 per hour.

Insurer Cannot Toll The Deadline For A Decision on the ERISA Appeal

Lewis-Burroughs v. Prudential Ins. Co. of Am., 2015 U.S. Dist. LEXIS 57584 (D.N.J. Apr. 30, 2015).

Judge Kevin McNulty of the New Jersey Federal District Court held that supplemental documentation submitted by us on behalf of a claimant during an ERISA appeal did not restart the clock for Prudential to decide the participant's appeal. Plaintiff, Tracee Lewis-Burroughs, timely appealed Prudential Insurance Company of America's decision to stop paying her long-term disability benefits. Shortly after she filed her appeal, Plaintiff submitted additional documentation to support her claim, which had not been requested by Prudential. Our firm filed suit when Prudential failed to decide the appeal within the required 90 days after submitting our initial appeal. Prudential moved to dismiss on the ground that Plaintiff failed to exhaust all of her administrative remedies; Prudential argued that it had 90 days from the date Plaintiff submitted her supplemental documentation, not 90 days from the date her appeal was initially submitted. According to the court, the 90-day clock did not restart upon the submission of the additional documentation.

Court Grants Summary Judgment For Plaintiff, finding Liberty Mutual’s Denial Arbitrary and Capricious

Stevens v. Santander Holdings USA, Inc., Civ. Action No.: 11-7473 (PGS) (D.N.J. Jan. 29, 2014).

Stevens suffers from ankylosing spondylitis and has been unable to work in his banking occupation due to pain associated with this terrible condition. Liberty denied his claim, based on biased medical reviewers who considered select portions of the medical records instead of fully and fairly reviewing the claim. Judge Sheridan found Liberty’s decision on the claim to be arbitrary and capricious, ordered short term disability benefits paid, and remanded the matter to Liberty to determine the long term disability claim. He ruled that due to our success on the merits of the case, our attorney’s fees must be paid by Defendants. Liberty has appealed the entire decision which is now before the United States Court of Appeals for the Third Circuit.

Court Remands Case to Johnson & Johnson To Conduct Vocational Analysis

Shvartsman v. Long Term Disability Income Plan for Choices Eligible Emples. of Johnson & Johnson, 2013 U.S. Dist. LEXIS 55145 (D.N.J. Apr. 12, 2013).

The Court determined that Johnson & Johnson failed to perform a proper vocational analysis to determine which “sedentary jobs” Mr. Shvartsman could allegedly perform, considering his physical and psychological abilities before denying his claim. The case was remanded to Johnson & Johnson and the case was confidentially settled.

Discovery Battles in New Jersey Continue

Shvartsman v. Johnson & Johnson, 2012 U.S. Dist. LEXIS 80328 (D.N.J. June 11, 2012).

This is one of many discovery opinions issued by the Court, specifically Magistrate Judge Bongiovanni, denying Bonny G. Rafel, Esq. discovery beyond the administrative record in ERISA matters. See also Stevens v. Santander Holdings USA, Inc., 2013 U.S. Dist. LEXIS 51548 (D.N.J. Apr. 10, 2013) . It is very rare in the State of New Jersey that discovery motions are granted in this area of the law, but Bonny G. Rafel, LLC persists; another motion is currently pending in Cimini v. Liberty Life Assurance Company of Boston, et al. In this matter, the Court denied all discovery requests, which were focused on establishing the bias of the medical reviewer's reliance on Johnson & Johnson. The Court held that the existence of "procedural abnormalities ... could open the door to discovery beyond the administrative record and a court may 'consider evidence of potential biases and conflicts of interest that is not found in the administrator's record.'" However, the Court ruled "that discovery beyond the administrative record would be unnecessary even if the Court determined that the alleged conflict of interest existed because conflict of interest should be considered only as 'a factor in determining whether Defendants abused its discretion in denying Plaintiff's benefits.'" Metro. Life Ins. Co. v. Glenn, 128 S. Ct. 2343, 2346 (U.S. 2008) .

Counsel Fees Paid For Success Once Litigation Has Been Filed

Hewel v. Long Term Disability Income Plan for Choices Eligible Emples. of Johnson & Johnson, 2010 U.S. Dist. LEXIS 67340 (D.N.J. July 7, 2010).

In this action, we filed litigation for Ms. Hewel when Defendant, Johnson & Johnson, failed to decide her ERISA appeal within the required 90 day deadline. Once in litigation, Defendants placed Ms. Hewel back on claim, reversing the denial, but refused to pay us counsel fees. We litigated the counsel fee issue, and the court agreed that due to our efforts, we had gained success on the merits. “By bringing the Complaint and through subsequent correspondence, plaintiff caused the Pension Committee to recognize her appeal of Reed Group’s decision.” The court granted all counsel fees.

Self-serving affidavit filed by Johnson & Johnson’s Director of Corporate Benefits in support of Its Motion for Summary Judgment is Barred and Exhibits Provided by Plaintiff to Establish Bias Permitted

Zurawel v. Long Term Disability Income Plan for Choices Eligible Emples. of Johnson & Johnson, 2010 U.S. Dist. LEXIS 102085 (D.N.J. Sept. 27, 2010).

In an ERISA litigation related to a self-insured plan of Johnson & Johnson, Defendant included an Affidavit by the Director of the Pension Committee, Richard McDonald, which sought to expand the administrative record in an attempt to buttress a comprehensive rationale for the denial of Plaintiff Russell Zurawel’s disability claims post hoc. The court excluded this Affidavit. Defendant cross-moved to exclude exhibits Plaintiff provided with his motion for summary judgment to show bias and procedural irregularity as a basis for the court to find that a conflict of interest skewed Defendant’s decision making. The court denied Defendant’s motion and the exhibits that we provided on behalf of our client, the Plaintiff, were considered by the court.

Lawyer disabled by depression and bipolar disorder is permitted to sue in pseudonym

Doe v. Hartford Life and Accident Ins. Co., 2006 U.S. Dist. LEXIS 73119 (D.N.J. 2006).

“Doe” was a lawyer who became disabled by symptoms of bipolar disorder. He sought to proceed in his case against Hartford under the fictitious name of “John Doe” from apprehension that litigation in federal court in his name would stigmatize him in the legal community, ruin his prospects of returning to work in the legal profession should he improve, and cause him to suffer tremendous anxiety. The court denied our motion to proceed in the litigation under a pseudonym and our motion for reconsideration based largely on public interest concerns rooted in the First Amendment’s right of public access to judicial proceedings. Judge Linares applied a balancing of the equities-type test, where the strong interest in ensuring public access to judicial proceedings is balanced against the private interests favoring anonymity. Plaintiff’s motion to appear in pseudonym was ultimately granted.

Options Floor Trader’s Bad Faith Claim Survives Summary Judgment Motion by Unum

Simon v. UnumProvident Corp., 2002 U.S. Dist. LEXIS 9331 (E.D. Pa. May 23, 2002).

Michael Simon (“Plaintiff”) suffered from depression and anxiety, which prevented him from working as an Options Floor Trader at the Philadelphia Stock Exchange in Philadelphia, Pennsylvania. Plaintiff sued his private disability income insurer, Paul Revere Life Insurance Company, Provident Companies, Inc. (“Provident”), Provident Life and Accident Insurance Company, and UnumProvident (the parent corporation) after his disability benefits were terminated for breach of contract, bad faith, unfair trade practices, consumer protection law violations, and civil conspiracy. The Court denied Defendants’ motion for summary judgment, finding that a material issue of fact existed as to whether Paul Revere functioned as the alter-ego of Provident/UnumProvident, where it exercised domination and control over Provident/UnumProvident’s affairs at the time Plaintiff's disability benefits were terminated. The Court also found that Plaintiff adduced sufficient evidence from which a jury could find under the stringent “clear and convincing evidence” standard that Defendants acted in bad faith. Bad faith existed in Defendants’ investigation of Plaintiff's claim and in its dealings with independent medical experts upon whose reports they allegedly based their decision to terminate Plaintiff's benefits. The case subsequently settled.

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