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Mealey's Disability Insurance

  • August 10, 2017

    Disability Insurer Did Not Breach Contract By Enforcing Offset Provision

    PHOENIX — An Arizona federal judge on Aug. 7 denied a disability claimant’s motion for partial summary judgment on the basis that the insurer did not breach its contract by enforcing the policy’s offset provision when it reinstated the claimant’s disability benefits (Benjamin McClure v. Country Life Insurance Company, et al., No. 15-2597, D. Ariz., 2017 U.S. Dist. LEXIS 123967).

  • August 8, 2017

    Federal Judge Dismisses Disability-Related Coverage Claims As Time-Barred

    SAN DIEGO — A California federal judge on Aug. 3 granted an insurer’s motion to dismiss claims for breach of contract and fraud in relation to its denial of long-term disability (LTD) benefits for a university employee, finding that all of the employee’s claims were untimely (Laurel Davis v. Liberty Life Assurance Company of Boston, No. 3:17-cv-00738, S.D. Calif., 2017 U.S. Dist. LEXIS 122776).

  • August 8, 2017

    Attorney Fees Awarded To Disability Claimant, But No Contingency Enhancement

    DETROIT — A Michigan federal judge on Aug. 1 granted a disability claimant’s motion for attorney fees because the claimant achieved a modest level of success on the merits, but the judge refused to apply a contingency enhancement, as requested by the claimant’s attorney, after determining that a contingency enhancement is not appropriate when using the lodestar model to calculate the appropriate amount of attorney fees (Kyle D. Kennard v. Means Industries Inc., No. 11-15079, E.D. Mich., 2017 U.S. Dist. LEXIS 120457).

  • August 2, 2017

    Plan Must Consider How Carpal Tunnel Affects Ability To Perform Own Occupation

    CHICAGO — An Illinois federal judge on July 31 vacated and remanded a disability plan’s denial of a long-term disability benefits claim after determining that the plan failed to consider how the claimant’s carpal tunnel syndrome would affect her ability to perform the duties of her own occupation (Jodi Suson v. The PNC Financial Services Group Inc. and Affiliates Long Term Disability Plan, et al., No. 15-10817, N.D. Ill., 2017 U.S. Dist. LEXIS 119473).

  • August 1, 2017

    Interpretation Of Plan’s Terms Was Reasonable Based On Extrinsic Evidence

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on July 28 affirmed a district court’s ruling that a pension plan had the discretion to decide which level of disability retirement benefits should be paid to a plan participant and that the interpretation of the plan’s terms by the plan’s board of trustees was reasonable based on the extrinsic evidence (Harold Davis v. Pension Trust Fund for Operating Engineers, et al., No. 15-17212, 9th Cir., 2017 U.S. App. LEXIS 13727).

  • August 1, 2017

    Disability Claimant Awarded Attorney Fees, Costs As The Prevailing Party

    LOS ANGELES — A California federal judge on July 24 awarded a disability claimant more than $100,000 in attorney fees and costs because the claimant prevailed on his claim for disability benefits (Avery Armani v. Northwestern Mutual Life Insurance Co., et al., No. 13-7058, C.D. Calif., 2017 U.S. Dist. LEXIS 117203).

  • July 28, 2017

    Plan Will Not Be Prejudiced If Disability Claimant Proceeds Under Pseudonym

    OAKLAND, Calif. — A California federal judge on July 26 granted a disability claimant’s motion to proceed under a pseudonym after determining that the need for anonymity outweighs prejudice to the defendant and the public’s interest in knowing the claimant’s identity (John Doe v. Lincoln National Life Insurance Co., No. 17-3963, N.D. Calif., 2017 U.S. Dist. LEXIS 117110).

  • July 27, 2017

    Federal Judge Remands A Portion Of Claim For Disability Benefits

    NEW YORK — A New York federal judge on July 24 adopted a federal magistrate’s recommendation to remand a long-term disability claim as it pertained to the claimant’s physical disability, but not the claimant’s psychiatric disability, because the evidence may support a finding that the claimant is physically disabled according to the terms of the plan (Marie Richter v. Metropolitan Life Insurance Co., No. 15-8266, S.D. N.Y., 2017 U.S. Dist. LEXIS 115119).

  • July 26, 2017

    Disability Claimant Met Burden Of Proving She Was Disabled Under Plan

    SAN FRANCISCO — A California federal judge on July 24 determined  that a disability claimant is entitled to long-term disability benefits because the claimant met her burden of proving that she was disabled according to the terms of the plan at issue (Hadar Meiri v. Hartford Life and Accident Insurance Co., No. 16-103, N.D. Calif., 2017 U.S. Dist. LEXIS 115224).

  • July 24, 2017

    Maryland Federal Judge: Denial Of Disability Benefits Was Arbitrary, Capricious

    BALTIMORE — A Maryland federal judge on July 21 granted a disability claimant’s motion for summary judgment after determining that a disability insurer’s denial of benefits was arbitrary and capricious because  substantial evidence does not support the denial (Wiley Joseph Smith v. The PNC Financial Services Group, et al., No. 15-2232, D. Md., 2017 U.S. Dist. LEXIS 113683).

  • July 20, 2017

    LTD Plan Is Ambiguous As To Whether Insurer’s Offset Was Permitted, Panel Says

    NEW ORLEANS — A district court did not err in finding that a disability insurer abused its discretion in offsetting a claimant’s long-term disability benefits because the plan is ambiguous as to whether a direct rollover of pension funds to an individual retirement account entitles the insurer to offset the claimant’s disability benefits, the Fifth Circuit U.S. Court of Appeals said July 18 (Joel Thomason v. Metropolitan Life Insurance Co., et al., No. 16- 10634, 5th Cir., 2017 U.S. App. LEXIS 12932).

  • July 20, 2017

    Alabama Federal Magistrate Recommends Disability Claim Be Remanded For Review

    DOTHAN, Ala. — An Alabama federal magistrate judge on July 13 recommended that a disability claimant’s motion for summary judgment be granted and that the claim be remanded to the plan administrator for consideration because the termination of benefits was not reasonable based on the medical evidence (Richard O. Shultz v. Aetna Life Insurance Co., et. al., No. 16-94, M.D. Ala., 2017 U.S. Dist. LEXIS 109654).

  • July 20, 2017

    Disability Plan’s Discretionary Authority Provision Is Void Under California Law

    SACRAMENTO, Calif. — A de novo standard of review must be applied in a denial of disability benefits suit because the disability plan’s discretionary authority provision is not valid under California law, a California federal judge said July 12 in granting the disability claimant’s motion for summary judgment (Renee Johnson Monroe v. Metropolitan Life Insurance Co., No. 15-2079, E.D. Calif., 2017 U.S. Dist. LEXIS 109012).

  • July 18, 2017

    Missouri Federal Judge Grants Limited Discovery In Disability Benefits Suit

    ST. LOUIS — A Missouri federal judge on July 11 partially granted a disability claimant’s motion for additional discovery, but only as it pertained to a plan administrator’s claims-handling guidelines, an administrative services agreement and a limited number of documents from a third-party vendor responsible for conducting independent medical reviews on behalf of the plan administrator (Teresa Heartsill v. Ascension Health Alliance, et al., No. 17-155, E.D. Mo., 2017 U.S. Dist. LEXIS 106749).

  • July 13, 2017

    11th Circuit Affirms Finding That Insurer’s Termination Of Benefits Was Reasonable

    ATLANTA — The 11th Circuit U.S. Court of Appeals on July 12 affirmed a district court’s ruling that a disability insurer’s termination of long-term care disability benefits was reasonable based on the evidence properly considered by the insurer (David Carr v. John Hancock Life Insurance Company USA, No. 16-17134, 11th Cir., 2017 U.S. App. LEXIS 12404).

  • July 13, 2017

    Insurer’s Vocational Assessment Was Not Flawed, Mississippi Federal Judge Says

    JACKSON, Miss. — A disability insurer’s denial of long-term disability benefits was not an abuse of discretion, a Mississippi federal judge said July 11 after rejecting the claimant’s argument that the insurer’s assessment of her occupation was flawed (Theresa A. Taylor v. The Prudential Insurance Company of America,  No. 12-702, S.D. Miss., 2017 U.S. Dist. LEXIS 106783).

  • July 7, 2017

    D.C. Appellate Panel: ERISA Plan Administrator Wrongfully Denied Woman Benefits

    WASHINGTON, D.C. — A District of Columbia appeals panel on June 30 said a federal judge correctly ruled that a woman was totally disabled under the terms of her Employee Retirement Income Security Act-governed long-term disability plan and that the plan administrator has not satisfactorily supported its conclusion that she was ever capable of full-time work after November 2007 (Jill Marcin v. Reliance Standard Life Insurance Co., et al., No. 16-78125, D.C. Cir., 2017 U.S. App. LEXIS 11670).

  • July 6, 2017

    Evidence Supports Termination Of Disability Benefits Based On Substance Abuse Provision

    CINCINNATI — A disability plan administrator did not act arbitrarily and capriciously when it terminated a claimant’s benefits based on the plan’s substance abuse provision because the evidence supports the administrator’s finding that the claimant’s disability was caused by the effects of opioid medications, the Sixth Circuit U.S. Court of Appeals said June 30 (Angela Blount v. United of Omaha Life Insurance Company, No. 16-6372, 6th Cir., 2017 U.S. App. LEXIS 11779).

  • July 6, 2017

    Disability Insurer’s Denial Of Benefits Supported By Medical Records, Panel Says

    ST. LOUIS — A disability insurer did not abuse its discretion in denying a claim for disability benefits because the medical records and evidence support the insurer’s denial, the Eighth Circuit U.S. Court of Appeals said July 5 (Michelle E. Cooper v. Metropolitan Life Insurance Company, No. 16-3429, 8th Cir., 2017 U.S. App. LEXIS 11933).

  • June 28, 2017

    Kentucky Federal Judge Denies Disability Claimant’s Motion To Strike Declaration

    LOUISVILLE, Ky. — A Kentucky federal judge on June 23 denied a disability claimant’s motion to strike a corporate representative’s declaration after determining that the declaration was properly submitted with the disability insurer’s motion for summary judgment (William Kennedy v. Life Insurance Company of North America, No. 15-741, W.D. Ky., 2017 U.S. Dist. LEXIS 97341).