For more than 25 years, the Law Office of Mark Scherzer (located in New York City) has advocated on behalf of consumers, policyholders, and employees to secure their rights to health, life and disability insurance benefits.
Our lawyers have experience with claims arising out of privately purchased insurance coverage -- such as individual health insurance, disability income policies and disability-triggered business overhead expense policies -- as well as employer-sponsored group insurance coverage -- such as short-term-disability plans, long-term-disability plans, life insurance plans (and disability waiver of premium benefits), disability retirement, and medical benefit plans (including retiree health coverage, COBRA continuation coverage).
Our lawyers are well-versed in New York insurance law, which typically governs individual insurance policies purchased in New York, and in the Employee Retirement Income Security Act, or ERISA, the federal law that typically governs employee group benefit plans. They provide a wide variety of attorney services -- including consultations, claim preparation, and claim denial appeals -- with regard to life, health, and disability insurance coverage under both ERISA plans and individual insurance policies.
Many of our clients have illnesses or conditions that are serious, chronic, and/or disabling, such as multiple sclerosis ("MS"), heart disease, depression, degenerative spine disease, chronic fatigue syndrome ("CFS"), Lyme disease, chronic pain syndrome, Parkinson's Disease, cancer and HIV/AIDS. Our lawyers help to obtain or keep appropriate coverage, to navigate the transition from employment to disability (or from disability back to work). Our attorneys are experienced advocates for the rights of claimants when insurers or employee benefit plans refuse to cover necessary treatments, deny disability benefits, or terminate long-standing disability claims. We routinely fight claim denials by filing ERISA internal appeals to challenged denied or terminated claims, pursuing New York external appeals to compel healthcare coverage, and commencing lawsuits, as necessary, to enforce the rights our clients.
Our lawyers have represented claimants with a broad range of occupations (including physicians, truck drivers, office managers, architects, stock brokers, film editors, attorneys, industrial and construction engineers, financial analysts, sales representatives, receptionists, computer/IT personnel, production managers, performing and visual artists and designers, and corporate executives) from a wide variety of employment settings. Not only do our attorneys provide guidance to employees facing the difficult choice of going out on short and long term disability, but also advise employees who are already out on disability leave about return-to-work issues, including the potential impact on their private or ERISA disability benefits, their COBRA continuation health insurance coverage, Medicare, and their Social Security disability benefits.
Our attorneys also represent and protect the common interests of our clients in a number of additional ways, by advocating with legislators and regulators for reforms in insurance law and policy; engaging in major test case litigation on behalf of public interest groups; and speaking at policy roundtables, bar training and education programs, and informational presentations to advocacy groups and their members.
Lawyer Mark Scherzer graduated from Yale Law School and trained at major New York law firms before devoting his professional life to enforcing the rights of the ill and disabled to insurance coverage and benefits. Lawyer A. Christopher Wieber graduated from Harvard Law School and also practiced at major New York law firms before joining Mr. Scherzer to advocate on behalf of those with disputed life, heath insurance and disability claims. When direct advocacy with insurance companies and employee benefit plans has failed, we have prosecuted lawsuits on behalf of our clients in both state and federal court.
49 Nassau Street
New York NY 10038
Insurance Law; Employee Benefits; COBRA; Disability Benefits; Employee Benefit Litigation; ERISA Litigation; Health Benefits; Health Care Legislation; Health Care Reform; Health Insurance; Health Insurance Coverage; Health Insurance Portability and Accountability Act (HIPAA); Health Law; Managed Care; Disability Insurance; Insurance Contracts; Insurance Coverage; Life and Health Insurance; Life Insurance; Insurance Litigation
1988, New York and U.S. District Court, Southern and Eastern Districts of New York; 1996, U.S. Court of Appeals, Second Circuit
Harvard University, J.D.
New York County Lawyers' Association.
Phi Beta Kappa. Co-Author: "Private Insurance," Ch. 12, AIDS and the Law, 4th Ed., Aspen Publishers, 2007. Speaker: "LSNY Employee Benefits Training," sponsored by Legal Services of New York, 2004; "LSNY Long Term Disability Benefits Training," sponsored by Legal Services of New York, 2003; "Insurance Issues Forum," sponsored by Gay Men's Health Crisis, Inc., 1992; "Discrimination and Unfair Practices in Insurance and Employee Benefits," at the Disability Discrimination in the Workplace Conference, co-sponsored by AIDS Network and American Civil Liberties Union of Wisconsin, 1999; "Insurance/Employee Benefits Panel," POZ Life Expo, sponsored by POZ Magazine, 1996. President, Board of Directors, 319 West 18th Street Owners' Corporation, 1998-2009. Cooperating Attorney: Lambda Legal Defense Fund; Gay Men's Health Crisis, Inc.
Massachusetts Casualty Ins. Co. v. Morgan, 886 F. Supp. 1002 (E.D.N.Y. 1995); Peterson v. Continental Cas Co., 77 F. Supp. 2d 420 (S.D.N.Y. 1999) and 116 F. Supp. 2d 532 (S.D.N.Y. 2000), aff'd in part, rvs'd in part, 282 F.3d 112 (2nd Cir., 2002).
Insurance Law; ERISA; Litigation; Lobbying; COBRA; Disability Benefits; Employee Benefit Litigation; ERISA Litigation; Health Benefits; Health Care Legislation; Health Care Reform; Health Insurance; Health Insurance Coverage; Health Insurance Portability and Accountability Act (HIPAA); Health Law; Managed Care; Disability Insurance; Insurance Contracts; Insurance Coverage; Life and Health Insurance; Life Insurance; Insurance Litigation
1979, New York and U.S. District Court, Southern District of New York; 1980, U.S. District Court, Eastern District of New York; 1985, U.S. Court of Appeals, Sixth Circuit; 1996, U.S. Court of Appeals, Second Circuit
Law School:Yale University, J.D.
New York County Lawyers Association; New Yorkers for Accessible Health Coverage (Member, Steering Committee; Legislative Counsel).
Recipient: Lambda Legal Defense, Jay C. Lipner Liberty Award, 1992; Community Service Award, Lesbian & Gay Law Association of Greater New York, 1992; Outstanding Service Award, Cancer Care, 1993. The Poz 50 (Most Influential AIDS Policymakers), Poz Magazine, Aug. - Sept. 1994; Certificate of Appreciation, American Bar Association, Commission on Women in the Profession Breast Cancer Initiative, 2002. Author: numerous practice guides and chapters on insurance issues, such as "AIDS Legal Guide," Lambda Legal Defense & Education Fund, Inc., 1984, 1988; "AIDS and the Law," Yale University Press, 1987; "Sexual Orientation and the Law," Clark Boardman Co., Ltd., 1987, 1991,1992, 1994, 1998; "AIDS Law Today," Yale University Press, 1993; "Life and Disability Insurance," Positive Options, Body Positive of New York, Inc., 1995; "Losing the Insurer of Last Resort: New York Should Rein in Empire," The New York Times, Op-Ed Page, January, 1996; "The Changing Environment, A Report to the HIV Health and Human Services Planning Council of New York," (Co-Authors, Mark Aurigemma, Ruth Finkelstein, David Hansell, Derek Hodel), September 1997; "On Their Own: Individuals Pay the Price of Insurance Market Breakdown," (Co-Authors, Susan Dooha, Brian Cassel, Rhon Reynolds), New York Community Trust, August 1999; "Freedom to Lose: How Oxford Is Compromising the Health of Chronically Ill Patients," (Co-Authors: Glen von Nostitz, Susan Dooha, Frank Salisbury), New Yorkers for Accessible Health Coverage, November 1999. Member, Technical Advisory Committee, New York State Insurance Department, 1992, 1995-1998; Speaker, Sheldon Silver's New York Health Advisory Board, 1995, 1999; Health Care and Insurance Steering Committee, National Endowment for the Arts, 1996-1997. Steering Committee, Artists Health Insurance Resource Center; Cooperating Attorney, Gay Men's Health Crisis, Inc.; Mentor and Trainer, Association of the Bar of the City of New York, Robert B. McKay Community Outreach Law Program, Cancer Advocacy Project, National Multiple Sclerosis Society Insurance Task Force. Member, Advisory Board of Legal Health.
Bronx, New York
Burke v. First UNUM Life Insurance Company of New York, 975 F. Supp. 310 (S.D.N.Y. 1997); Bradley v. Empire Blue Cross & Blue Shield, 562 N.Y.S. 2d 908 (Sup. Ct., N.Y. Co. 1990); Doe v. United Services Life Insurance Co., 123 F.R.D. 437 (S.D.N.Y. 1988); Fay v. Oxford Health Plan, 287 F.3d 96 (2d Cir. 2002); Fortune v. Medical Associates of Woodhull, 803 F. Supp. 636 (E.D.N.Y. 1992); Massachusetts Casualty Ins. Co. v. Morgan, 886 F. Supp. 1002 (E.D.N.Y. 1995); New England Mutual Life Insurance Co. v. Doe, 93 N.Y. 2d 122 (1999); Swensen v. Colonial Life Insurance Co. of America, 1993 WL 378470 (S.D.N.Y. 1993); Whitney v. Empire Blue Cross and Blue Shield, 920 F. Supp. 477 (S.D.N.Y. 1996); rev'd and remanded 106 F.3d 475 (2d Cir. 1997); Troy v. Unum Life Ins. Co. of America, 2006 U.S. Dist. LEXIS 14965 (S.D.N.Y., Mar. 31. 2006); Noia v. Division 1181 ATU - New York Welfare Fund, 2007 U.S. Dist. LEXIS 68324 (E.D.N.Y., Sep. 14, 2007); Zurndorfer v. Unum Life Ins. Co. of America, 543 F. Supp. 2d 242 (S.D.N.Y., 2008).