Legal Memorandum: Coverage Denial to a Covered Person–US

Issue: Can a union health fund can deny coverage to a covered person because the covered person failed to submit an accident questionnaire within 60 days from the request according to law nationwide?

Area of Law: Insurance Law
Keywords: Coverage Denial; Accident questionnaire; Union health fund
Jurisdiction: Federal
Cited Cases: 134 F.3d 939; 13 F. Supp. 2d 696
Cited Statutes: None
Date: 04/01/2014

The following authorities discuss this question:

Patterson v. Reliance Standard Life Ins. Co., No. EDCV 13-0211 JGB (OPx) (C.D. Cal. Dec. 4, 2013).  

Baptist Mem. Hosp. v. Marsaw, 13 F. Supp. 2d 696 (W. D. Tenn. 1988).

Cisneros v. UNUM Life Ins. Co. of Am., 134 F.3d 939 (9th Cir. 1998).

McInnis v. Provident Life & Accident Ins. Co., 853 F. Supp. 880 (M.D.N.C. 1993).

E.J. ex rel. her parents v. Montana Contractors’ Ass’n Healthcare Trust, 448 Fed. App’x 765 (9th Cir. 2011) (unpublished)

Pearce v. Paul Revere Life Ins. Co., No. Civ. 01-665 PAM/RLE (D. Minn. Aug. 23, 2002).


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