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Mealey's Disability Insurance

  • August 16, 2019

    Arbitrary, Capricious Standard Of Review Applies, Federal Judge Says

    CHICAGO — An Illinois federal judge on Aug. 15 determined that an arbitrary and capricious standard of review must be applied to a disability dispute because the plan’s discretionary clause is valid and enforceable (Kathleen A. Brubaker v. The Hartford Life and Accident Insurance Co., No. 18-4995, N.D. Ill., 2019 U.S. Dist. LEXIS 137777).

  • August 14, 2019

    Alabama Federal Judge Awards Disability Claimant Attorney Fees, Costs

    DOTHAN, Ala. — An Alabama federal judge on Aug. 13 awarded a disability claimant attorney fees and costs after determining that the claimant achieved some degree of success on the merits and after finding that the disability insurer acted with culpability as it failed to consider all relevant information before making a benefits determination (Richard P. Shultz v. Aetna Life Insurance Co., et al., No. 16-94, M.D. Ala., 2019 U.S. Dist. LEXIS 135979).

  • August 13, 2019

    Judge Denies Motion To Strike Declarations Submitted By Insurer In Disability Suit

    LOUISVILLE, Ky. — A Kentucky federal judge on Aug. 12 denied a disability claimant’s motion to strike two declarations attached to a disability insurer’s motion for summary judgment after determining that the declarations are not sham affidavits and help to fill in the gaps of incomplete sworn testimony (Richard E. Davis v. Hartford Life & Accident Insurance Co., No.. 14-507, W.D. Ky., 2019 U.S. Dist. LEXIS 135388).

  • August 12, 2019

    STD Claim Remanded; Claimant Denied Full, Fair Review, Judge Says

    LAS VEGAS — A Nevada federal judge on Aug. 8 remanded a short-term disability (STD) claim to the plan administrator because the record reflects that the claimant was denied a full and fair review when the disability insurer denied the STD claim before receiving medical records from the claimant’s treating physicians (Paul Speca v. Aetna Life Insurance Co., No. 18-835, D. Nev., 2019 U.S. Dist. LEXIS 134166).

  • August 12, 2019

    Florida Federal Judge Dismisses Disability Suit, Says Claims Are Untimely

    FORT LAUDERDALE, Fla. — A Florida federal judge on Aug. 8 dismissed a disability claimant’s amended complaint with prejudice after determining that the claimant cannot successfully allege breach of contract and bad faith claims against the insurer because they are barred by the policy’s three-year limitations provision and Delaware’s applicable three-year statute of limitations (Douglas Kuber v. The Prudential Insurance Company of America, No. 19-80151, S.D. Fla., 2019 U.S. Dist. LEXIS 134537).

  • August 9, 2019

    Federal Judge Says Disability Claimant’s Suit Is Barred By Res Judicata

    LOS ANGELES — A disability claimant’s suit seeking long-term disability (LTD) benefits must be dismissed because the LTD claim was disposed of in a prior lawsuit filed by the claimant against the disability insurer, a California federal judge said Aug. 7 (Yvette Williby v. Aetna Life Insurance Co., No. 18-10639, C.D. Calif., 2019 U.S. Dist. LEXIS 133814).

  • August 8, 2019

    Disability Claimant Says High Court Should Review Fraud On Court Ruling

    WASHINGTON, D.C. — A disability claimant on July 15 filed a petition for writ of certiorari in the U.S. Supreme Court, arguing that review of the Sixth Circuit U.S. Court of Appeals’ ruling that the claimant’s attorney did not commit fraud upon the court is warranted because the record clearly shows that fraud upon the court was committed and that the claimant’s constitutional rights were violated as a result of the fraud (Kyle D. Kennard v. Means Industries Inc., No. 19-98, U.S. Sup., 2019 U.S. S. Ct. Briefs LEXIS 2682).

  • August 8, 2019

    Disability Claimant Seeks High Court Review On Any-Occupation Standard

    PHILADELPHIA — The U.S. Supreme Court should review 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 because a conflict exists among the circuit courts as to whether it would be futile for the disability claimant on remand to seek benefits under a plan’s any-occupation standard if benefits were previously denied under a plan’s own-occupation standard, the disability claimant maintains in a July 26 petition for writ of certiorari (Thomas P. Kelly Jr. v. Reliance Standard Life Insurance Co., et al., No. 18-1162, 3rd Cir.).

  • August 6, 2019

    Bad Faith Claim Against Disability Insurer Will Proceed, Judge Says

    SAN JOSE, Calif. — A bad faith claim alleged against a disability insurer can proceed because questions of fact exist as to whether the insurer’s termination of long-term disability benefits was unreasonable and as to whether the bad faith claim is subject to the applicable two-year statute of limitations, a California federal judge said Aug. 2 in denying the insurer’s motion for summary judgment (Stephanie Jensen v. Dearborn National Life Insurance Co., No. 17-7320, N.D. Calif., 2019 U.S. Dist. LEXIS 129835).

  • August 5, 2019

    Fiduciary Exception Does Not Apply To Subrogation Communication, Judge Says

    SCRANTON, Pa. — A Pennsylvania federal judge on July 29 partially denied a disability insurer’s motion for a protective order regarding information sought in depositions after determining that the fiduciary exception to the attorney-client privilege does not apply to communications regarding the administration of the disability plan concerning subrogation shared among the plan, its fiduciaries and any attorney assisting in the administration of the plan prior to the filing of the disability claimant’s lawsuit (Eric Yost, et al. v. Anthem Life Insurance Co., No. 3:16-cv-00079, M.D. Pa., 2019 U.S. Dist. LEXIS 125967).

  • July 31, 2019

    Plan Correctly Found Claimant Did Not Qualify For Disability Benefits

    PHILADELPHIA — A pension plan’s board of trustees did not act arbitrarily or capriciously when it determined that a plan participant’s vacation pay does not count as benefit hours, the Third Circuit U.S. Court of Appeals said July 24 in affirming a district court’s ruling that the plan participant is not entitled to disability benefits under the pension plan because the participant did not meet the required hours of service necessary to collect disability benefits (Norman Hansen v. International Union of Painters & Allied Trades Industry Pension Plan, et al., No. 18-2921, 3rd Cir., 2019 U.S. App. LEXIS 22066).

  • July 31, 2019

    Panel Majority Affirms Denial Of Remand In Disability Dispute

    CINCINNATI — A Sixth Circuit U.S. Court of Appeals panel majority on July 18 affirmed a district court’s denial of a disability claimant’s motion to remand, agreeing with the lower court that the insurer proved by a preponderance of the evidence that the amount in controversy exceeds $75,000 (James Heyman v. Lincoln National Life Insurance Co., No. 18-5622, 6th Cir., 2019 U.S. App. LEXIS 21254).

  • July 30, 2019

    Committee’s Interpretation Of Disability Plan Was Abuse Of Discretion, Judge Says

    LAKE CHARLES, La. — A disability plan committee’s interpretation of plan documents was an abuse of discretion because the disability plan was ambiguous as to whether a written application for disability retirement benefits was required, a Louisiana federal judge said July 22 in granting a disability claimant’s motion for summary judgment (John R. Ketchum v. Saint-Gobain Corp., No. 18-562, W.D. La., 2019 U.S. Dist. LEXIS 123743).

  • July 30, 2019

    Disability Claimant Is Entitled To Attorney Fees, But No Prejudgment Interest

    BAY CITY, Mich. — A Michigan federal judge on July 26 awarded a disability claimant attorney fees and costs but refused to award the claimant prejudgment interest because the claimant did not obtain a monetary award against the disability insurer (Kimberly Guest-Marcotte v. Life Insurance Company of North America, No. 15-10738, E.D. Mich., 2019 U.S. Dist. LEXIS 125061).

  • July 30, 2019

    Federal Judge Says Finding In Favor Of Disability Claimant Was Not Clear Error

    SALT LAKE CITY — A Utah federal judge on July 25 denied a disability insurer’s motion to alter or amend an opinion finding that a disability claimant is eligible for disability benefits after determining that the decision was not clear error and was not contrary to precedent established by the 10th Circuit U.S. Court of Appeals (David G. Carlile v. Reliance Standard Insurance Co., No. 17-1049, D. Utah, 2019 U.S. Dist. LEXIS 125026).

  • July 29, 2019

    Disability Claimant Failed To File Suit Within Plan’s 3-Year Limitation Provision

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on July 25 affirmed a district court’s dismissal of a disability claimant’s suit because the claimant clearly failed to file suit within three years of the accrual of his claim as required by the plan (Michael Faciane v. Sun Life Assurance Company of Canada, No. 18-30918, 5th Cir., 2019 U.S. App. LEXIS 222320).

  • July 23, 2019

    Policy Rider Does Not Apply To Plaintiff’s Disability Income Policy, Judge Says

    SACRAMENTO, Calif. — A California federal judge on July 18 dismissed a disability claimant’s suit after determining that a rider that ended the application of mental disorder limitations did not apply to the claimant’s disability income policy because the rider attached only to disability income policies with a duration of two years or less (Joy Wiseblood v. Mutual of Omaha Insurance Co., et al., No. 18-3082, E.D. Calif., 2019 U.S. Dist. LEXIS 120210).

  • July 22, 2019

    Disability Insurer’s Denial Of Benefits Was Reasonable Based On Medical Evidence

    MONTGOMERY, Ala. — A disability insurer did not act arbitrarily and capriciously in denying total disability benefits to a claimant because the insurer’s decision was reasonable based on the medical evidence, an Alabama federal judge said July 12 (Anthony Bowman v. Reliance Standard Life Insurance Co., No. 11-1046, M.D. Ala., 2019 U.S. Dist. LEXIS 116110).

  • July 22, 2019

    Judge Dismisses Civil Conspiracy Claim Against Disability Life Insurer

    MONTGOMERY, Ala. — An Alabama federal judge on July 17 dismissed a civil conspiracy claim against a disability life insurer in an insured’s breach of contract and bad faith case against the insurer and a reinsurer over the denial of disability benefits (Horace R. Theriot Jr. v. The Northwestern Mutual Life Insurance Co., et al., No. 18-688, M.D. Ala.).

  • July 16, 2019

    Disability Claimant Exhausted Lifetime Maximum For Partial Disability Benefits

    BOSTON — A Massachusetts federal judge on July 11 granted summary judgment in favor of a disability plan after determining that the plan’s termination of partial disability benefits was not arbitrary and capricious because the claimant exhausted the plan’s lifetime maximum for partial disability benefits and the medical evidence supported the plan’s finding that the claimant was not totally disabled (Donald Hammond v. Procter & Gamble Health and Long Term Disability Plan, No. 18-11343, D. Mass., 2019 U.S. Dist. LEXIS 115105).