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Life & Health Insurance & ERISA Claims

For many years, Semmes has maintained an active and diverse practice representing numerous insurance companies, third party administrators and employers in the Middle Atlantic Region in response to claims for benefits under welfare benefit plans and group and individual policies. We have defended a wide variety of matters in the state and federal trial and appellate courts of Maryland, the District of Columbia and Northern Virginia concerning claims under group and individual life, disability and health insurance contracts. The practice includes defense of claims under ERISA-governed employee welfare benefit plans.

Representative types of matters in which we have been involved have included:

  • fraudulent foreign death claims
  • defense of claims on individual and group life, health and disability insurance contracts
  • interpleader of policy proceeds in state and federal courts
  • rescission of policies and defense of claims involving misrepresentation in the inception
  • suicide and accidental death cases

In recent years, this practice has involved frequent experience with mediation of such disputes.

The Firm’s attorneys also represent our diverse client base with respect to insurance regulatory matters before the Maryland Insurance Administration and the District of Columbia Department of Insurance Securities and Banking with respect to:

  • acquisitions
  • company and agent licensing
  • complaints and investigations
  • policy forms approvals
  • insolvency matters
  • mandated coverage problems
  • market conduct examinations

Attorneys involved in this practice area are actively engaged in various professional and industry associations. Alan N. Gamse is a former Chair and active member of the Insurance Regulation Committee (formerly Public Regulation of Insurance Law Committee) and former Co Chair of the Self Insurance and Risk Managers Committee of the Tort Trial and Insurance Practice Section of the American Bar Association. Mr. Gamse is also an active member of the Federation of Regulatory Counsel and the International Association of Insurance Receivers.

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