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Mealey's Disability Insurance

  • October 17, 2019

    Disability Claimant Says Termination Of Benefits Was Breach Of Contract

    FRESNO, Calif. — A disability insurer acted in bad faith and breached its contract in terminating a claimant’s long-term disability (LTD) benefits because the insurer’s termination was not reasonable and not based on reliable medical evidence, the claimant alleges in an Oct. 15 complaint filed in California federal court (Jennifer Sims v. Life Insurance Company of North America, No. 19-1460, E.D. Calif.).

  • October 15, 2019

    Disability Claimant’s Allegations Are Preempted Under ERISA, Judge Says

    ASHLAND, Ky. — A Kentucky federal judge on Oct. 3 granted a disability insurer’s motion to dismiss after determining that all of the claims alleged against the insurer arise out of its handling of a disability claim and, therefore, are preempted by the Employee Retirement Income Security Act (Lorey Lowe v. Lincoln National Life Insurance Corp., et al., No. 19-31, E.D. Ky., 2019 U.S. Dist. LEXIS 171691).

  • October 14, 2019

    Arbitrary, Capricious Standard Of Review Applies, Kentucky Federal Judge Says

    LEXINGTON, Ky. — An arbitrary and capricious standard of review must be applied in a disability suit because the disability plan clearly provided the insurer with discretionary authority, a Kentucky federal judge said Oct. 11 (Jennifer Lee Smith v. Hartford Life & Accident Insurance Co., No. 19-61, E.D. Ky., 2019 U.S. Dist. LEXIS 176874).

  • October 09, 2019

    Disability Claimant’s Suit Is Barred Based On Release Signed By Claimant

    WASHINGTON, D.C. — A disability claimant is barred from filing suit against his former employer’s disability plan administrator and disability insurer because the claimant signed a release as part of his separation agreement from the company and waived any right to any claims against his employer and certain other entities, a District of Columbia federal judge said Oct. 7 (Kim Keister v. AARP Benefits Committee, et al., No. 18-2385, D. D.C., 2019 U.S. Dist. LEXIS 173244).

  • October 07, 2019

    High Court Denies Review Of Claimant’s Petition On Any-Occupation Standard

    WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 7 denied a disability claimant’s petition for writ of certiorari, refusing to consider the Third Circuit U.S. Court of Appeals’ finding that a district court properly remanded a claim for long-term disability (LTD) benefits to determine whether benefits are available under a plan’s any-occupation standard (Thomas P. Kelly Jr. v. Reliance Standard Life Insurance Co., et al., No. 19-146, U.S. Sup.).

  • October 07, 2019

    High Court Denies Disability Claimant’s Petition On ‘Regular Occupation’ Ruling

    WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 7 refused to review the Fifth Circuit U.S. Court of Appeals’ ruling in favor of a disability insurer on the insurer’s interpretation of the term “regular occupation” (Juanita Nichols v. Reliance Standard Life Insurance Co., No. 19-242, U.S. Sup.).

  • October 07, 2019

    Disability Claimant’s Petition Denied; 6th Circuit’s Fraud On Court Ruling Stands

    WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 7 denied a disability claimant’s pro se petition for writ of certiorari, refusing to review the Sixth Circuit U.S. Court of Appeals’ ruling that the claimant’s attorney did not commit fraud upon the court (Kyle D. Kennard v. Means Industries Inc., No. 19-98, U.S. Sup.).

  • October 04, 2019

    Texas Federal Magistrate Says Tortious Interference Claim Should Proceed

    AUSTIN,  Texas — A Texas federal magistrate judge on Oct. 3 recommended denying a disability insurer’s motion to dismiss a claim for tortious interference with a business relationship after determining that the claim is not preempted by the Employee Retirement Income Security Act and that the disability claimant sufficiently alleged facts in support of his claim that the disability insurer interfered with his relationship with a consultant and an attorney who were handling his claim for Social Security disability benefits (Juan Pensado v. Life Insurance Company of North America et al., No. 19-157, W.D. Texas, 2019 U.S. Dist. LEXIS 171870).

  • October 02, 2019

    Termination Of Disability Benefits Was Not Reasonable; Judge Reinstates Benefits

    RIVERSIDE, Calif. — A California federal judge on Sept. 30 reversed a disability plan administrator’s termination of long-term disability (LTD) benefits and ordered that the benefits be reinstated after determining that the medical evidence supports a finding that the claimant is disabled from working in any occupation (Julie Hinds v. Life Insurance Company of North America, No. 18-775, C.D. Calif., 2019 U.S. Dist. LEXIS 169478).

  • October 01, 2019

    Termination Of Disability Benefits Was Not Arbitrary, Capricious, Judge Says

    PORTLAND, Maine — A disability insurer’s termination of long-term disability (LTD) benefits based on its finding that the claimant was not disabled from performing the duties of any occupation was reasonable based on the medical evidence and was not arbitrary and capricious, a Maine federal judge said Sept. 26 (Mitchell A. Weeman v. Life Insurance Company of North America, No. 18-278, D. Me., 2019 U.S. Dist. LEXIS 165369).

  • September 30, 2019

    Insurer’s Breach Of Contract Claim Against Broker In Disability Suit To Proceed

    SAN FRANCISCO —  A California federal judge on Sept. 27 denied a wholesale insurance broker’s motion to dismiss a cross-complaint filed a by an insurer in a breach of contract and bad faith disability coverage dispute after determining that the insurer sufficiently alleged facts in support of its breach of contract claim (Andre Ward v. Certain Underwriters at Lloyd’s of London, et al., No. 18-7551, N.D. Calif., 2019 U.S. Dist. LEXIS 167284).

  • September 26, 2019

    Taxes Must Be Deducted From Disability Claimant’s Settlement, Judge Says

    HUNTINGTON, W.Va.— A West Virginia federal judge on Sept. 25 denied a disability claimant’s motion to enforce a settlement without a deduction for applicable tax withholding after determining that the plan at issue and the Internal Revenue Service require that taxes be withheld from the settlement amount because the settlement clearly qualifies as replacement wages for tax purposes (Noel Jordan v. AT&T Integrated Disability Service Center Disability Plan, et al., No. 18-94, S.D. W.Va., 2019 U.S. Dist. LEXIS 164015).

  • September 26, 2019

    LTD Benefits Must Be Reinstated, Utah Federal Judge Determines

    SALT LAKE CITY — A Utah federal judge on Sept. 24 determined that a disability claimant’s long-term disability (LTD) benefits must be reinstated because the insurer’s termination of benefits was arbitrary and capricious based on the lack of medical evidence to support its termination (Don Foust v. Lincoln National Life Insurance Co., No. 17-1208, D. Utah, 2019 U.S. Dist. LEXIS 164576).

  • September 25, 2019

    Denial Of LTD Benefits Was Arbitrary, Capricious, Federal Judge Determines

    ASHLAND, Ky. — A Kentucky federal judge on Sept. 24 remanded a long-term disability (LTD) claim and life insurance with waiver of premium (LWOP) claim to the disability plan administrator after determining that the  administrator’s termination of LTD and LWOP benefits was arbitrary and capricious (Lewis Bustetter v. Standard Insurance Co., No. 18-1, E.D. Ky., 2019 U.S. Dist. LEXIS 163075).

  • September 24, 2019

    Disability Claimant’s Suit To Remain In Massachusetts, Federal Judge Says

    WORCESTER, Mass. — A Massachusetts federal judge on Sept. 20 denied a motion to transfer a disability claimant’s suit to Kansas federal court after determining that the disability insurer defendants failed to prove that private or public interest factors weigh in favor of transferring the case (Mary MacNaughton v. Paul Revere Life Insurance Co. & Unum Group, No. 19-40016, D. Mass., 2019 U.S. Dist. LEXIS 160454).

  • September 23, 2019

    Insured’s Claims Related To Disability Payment Are Barred By Statute Of Limitations

    SAN DIEGO — A California federal judge on Sept. 17 granted an insurer’s motion for judgment on the pleadings after determining that an insured’s claims related to an alleged missed disability income payment are barred by the applicable statute of limitations (Renato Openiano v.  Hartford Life and Annuity Insurance  Co., et al., No. 18-943, S.D. Calif., 2019 U.S. Dist. LEXIS 160005).

  • September 20, 2019

    Disability Claimant Provided Final Opportunity To File Summary Judgment Response

    SACRAMENTO, Calif. — A California federal magistrate judge on Sept. 17 denied a disability insurer’s motion to grant summary judgment on a disability claimant’s remaining claims based on the claimant’s failure to file a response to the insurer’s motion and allowed the claimant one final opportunity to file a response after determining that an extension is warranted based on the claimant’s pro se status (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2019 U.S. Dist. LEXIS 159246).

  • September 19, 2019

    Disability Claimant’s Opinions Are Not Relevant To Breach Of Contract Claim, Judge Says

    WILLIAMSPORT, Pa. — A Pennsylvania federal judge on Sept. 17 determined that a disability claimant’s opinions on the handling of his claim must be excluded from trial because the claimant’s opinions are not relevant to the breach of contract claim and would be prejudicial to the disability insurer and that the claimant’s expert witnesses cannot testify as to whether the claimant is disabled from his own occupation as a dentist because the experts do not have sufficient knowledge of the claimant’s occupational duties (Dr. Robert Brugler v. Unum Group, et al., No. 15-1031, M.D. Pa., 2019 U.S. Dist. LEXIS 158503).

  • September 18, 2019

    Extra-Record Discovery Request Granted In Disability Dispute

    GREENBELT, Md. — A Maryland federal judge on Sept. 5 issued a letter order granting a disability claimant’s motion for extra-record discovery after determining that the claimant met her burden of establishing that the administrative record does not provide sufficient evidence to address her claim that the disability insurer’s termination of benefits was affected by a conflict of interest (Holly Chughtai v. Metropolitan Life Insurance Co., No. 19-848,  D. Md., 2019 U.S. Dist. LEXIS 154304).

  • September 16, 2019

    Federal Judge Reinstates LTD Benefits, Says Insurer’s Termination Is Not Supported

    AKRON, Ohio — An Ohio federal judge on Sept. 11 reinstated a disability claimant’s long-term disability (LTD) benefits after determining that the termination of her benefits was arbitrary and capricious because the insurer selectively reviewed the medical evidence to support its denial (Kristina Rossiter v. Life Insurance Company of North America, No. 18-1421, N.D. Ohio, 2019 U.S. Dist. LEXIS 155126).