Mealey's Disability Insurance

  • March 22, 2017

    Claimant No Longer Disabled Under Plan’s Terms, Indiana Federal Judge Says

    INDIANAPOLIS — The termination of a claimant’s long-term disability benefits was not arbitrary and capricious because the claimant was not disabled from “any gainful occupation,” an Indiana federal judge said March 17 (Jill A. Stafford v. Anthem Life Insurance Co., et al., No. 15-2032, S.D. Ind., 2017 U.S. Dist. LEXIS 38564).

  • March 22, 2017

    Minnesota Federal Judge: Plan’s Denial Of Benefits Was Not Arbitrary And Capricious

    MINNEAPOLIS — A benefit plan did not act arbitrarily and capriciously in denying a participant’s claim for short-term disability benefits because substantial evidence supports the plan’s finding that the participant was able to return to work, a Minnesota federal judge said March 17 (Jeremy Braden v. AT&T Umbrella Benefit Plan No. 3, No. 16-729, D. Minn., 2017 U.S. Dist. LEXIS 39030).

  • March 16, 2017

    Judge Denies Insured’s Remand Motion In Insurance Bad Faith Suit

    COLUMBUS, Ohio — Remand of an insurance breach of contract and bad faith lawsuit to state court is not proper because the amount in controversy exceeds the statutory limit, a federal judge in Ohio ruled March 13 (Leslie Wyatt v. New England Mutual Life Insurance Co., et al., No. 17-40, S.D. Ohio, 2017 U.S. Dist. LEXIS 35504).

  • March 16, 2017

    Breach Of Contract Claim Completely Preempted By ERISA, Federal Judge Says

    SAN DIEGO — A California federal judge on March 13 denied a disability claimant’s motion to remand and granted a disability insurer’s motion to dismiss after determining that a breach of contract claim is completely preempted by the Employee Retirement Income Security Act and fails to state a claim upon which relief can be granted (James Heldt v. Guardian Life Insurance Company of America, No. 16-885, S.D. Calif.; 2017 U.S. Dist. LEXIS 36490).

  • March 16, 2017

    Insurer Was Not Estopped From Terminating Benefits, Tennessee Federal Judge Says

    GREENVILLE, Tenn. — A Tennessee federal judge on March 13 adopted a magistrate judge’s report and recommendation to deny a disability claimant’s motion for summary judgment after finding no basis for the claimant’s objection that the insurer was estopped from terminating his disability benefits (Robert Justice v. Reliance Standard Life Insurance Co., No. 15-134, E.D. Tenn., 2017 U.S. Dist. LEXIS 35388).

  • March 13, 2017

    District Court Erred By Reducing Attorney Fees, Claimant Argues On Appeal

    BOSTON — A disability claimant who successfully recovered benefits from a disability insurer argues in a Feb. 27 reply brief filed in the First Circuit U.S. Court of Appeals that a district court failed to promote the goal of making the claimant whole under the Employee Retirement Income Security Act (ERISA) when it limited the amount of prejudgment interest and reduced the amount of attorney fees the claimant could collect from the insurer (Diahann L. Gross v. Sun Life Assurance Company of Canada, Nos. 16-2002, 16-1958, 1st Cir.).

  • March 9, 2017

    Decision To Terminate Partial Benefits Was Reasonable, Judge Says

    CHARLOTTE, N.C. — A disability insurer’s decision to terminate a claimant’s partial disability benefits was reasonable because the insurer worked with the claimant when prorating the claimant’s quarterly bonus and the claimant did not object to the method used by the insurer to prorate the bonus, a North Carolina federal judge said March 2 (Frederick Sutherland v. Sun Life Assurance Company of Canada, No. 16-182, W.D. N.C., 2017 U.S. Dist. LEXIS 29628).

  • March 9, 2017

    Alabama Federal Judge Says Insurer’s Interpretation Was Arbitrary And Capricious

    MONTGOMERY, Ala. — A disability insurer’s interpretation of a tolling provision to extend the 45-day time deadline to decide an administrative appeal was arbitrary and capricious, an Alabama federal judge said March 7 in partially adopting a magistrate judge’s recommendation to deny the insurer’s motion for summary judgment (Melissa Stevens v. Sun Life and Health Insurance Co. [U.S.], No. 16-76, M.D. Ala., 2017 U.S. Dist. LEXIS 31734).

  • March 8, 2017

    New York Federal Judge Awards Attorney Fees To Disability Claimant

    ROCHESTER, N.Y. — A New York federal judge on March 6 determined that a disability claimant is entitled to more than $34,000 in attorney fees because the claimant was the prevailing party on motions for summary judgment (Charles Standish v. Federal Express Corp. Long Term Disability Plan, et al., No. 6:15-cv-6226, W.D. N.Y., 2017 U.S. Dist. LEXIS 31400).

  • March 6, 2017

    Denial Of Benefits Was Not Arbitrary Or Capricious, Tennessee Federal Judge Says

    KNOXVILLE, Tenn. — Because there was evidence supporting the conclusion that a disability claimant was able to perform a material and substantial duty of her occupation, a disability insurer’s denial of her claim for benefits was not arbitrary or capricious, a Tennessee federal judge said March 1 in adopting a magistrate judge’s report and recommendation (Kimberly D. Buchanan v. Sun Life and Health Insurance Co., No. 15-202, E.D. Tenn., 2017 U.S. Dist. LEXIS 28513).

  • March 3, 2017

    California Federal Judge OKs Settlement In Dispute Over Offset Of Veterans’ Benefits

    OAKLAND, Calif. — A California federal on March 1 approved a class action settlement between former U.S. veterans and Liberty Life Assurance Company of Boston after determining that the terms of the settlement, which provides compensation to class members whose disability benefits were offset or reduced by Liberty Life, are reasonable (James L. Bush v. Liberty Life Assurance Company of Boston, et al., No. 14-1507, N.D. Calif.).

  • March 2, 2017

    LTD Plan Was Not Granted Discretionary Authority, 1st Circuit Panel Determines

    BOSTON — The First Circuit U.S. Court of Appeals on March 1 reversed a federal court’s ruling that a disability insurer was delegated with discretionary authority and directed the lower court to review a claimant’s termination of benefits under a de novo standard of review (Nilda Rodriguez-Lopez v. Triple-S Vida, Inc., No. 15-2413, 1st Cir., 2017 U.S. App. LEXIS 3729).

  • March 2, 2017

    New York Federal Judge Says Administrator Failed To Prove Extension Was Warranted

    NEW YORK — Because a plan administrator failed to prove that special circumstances existed when it extended the allowable time to issue a decision on appeal, a New York federal judge on Feb. 28 concluded that a de novo standard of review is appropriate (Katherine Salisbury v. Prudential Insurance Company of America, No. 15-9799, S.D. N.Y., 2017 U.S. Dist. LEXIS 27983).

  • March 1, 2017

    Georgia Federal Judge Says Beneficiary Has Adequate Remedy Under ERISA

    ATLANTA — Because a beneficiary seeking supplemental life insurance benefits for a plan participant’s disability has an adequate remedy under Section 502(a)(1)(B) of the Employee Retirement Income Security Act and failed to provide support for a separate breach of fiduciary duty claim, a Georgia federal judge on Feb. 27 dismissed the breach of fiduciary claim alleged against the plan (Stephanie D. Vaughn v. Aetna Life Insurance Co., No. 16-1107, N.D. Ga., 2017 U.S. Dist. LEXIS 26743).

  • March 1, 2017

    10th Circuit Panel Finds No Evidence That Employer Created Hostile Environment

    DENVER — The 10th Circuit U.S. Court of Appeals on Feb. 24 affirmed that an employer did not create a hostile work environment after learning of an employee’s disability because the employee failed to submit sufficient evidence that he was subject to a hostile work environment as a result of his disability (Steven R. Williams v. FedEx Corporate Services, et al., No. 16-4032, 10th Cir., 2017 U.S. App. LEXIS 3364).

  • February 27, 2017

    9th Circuit Panel Upholds Plan’s Offset Of Disability Benefits

    SAN FRANCISCO — Plan language clearly allowed an insurer to offset permanent partial disability benefits by the amount of long-term disability benefits the employee received, a Ninth Circuit U.S. Court of Appeals panel held Feb. 16 in an unpublished opinion (John Del Gallego v. Wells Fargo & Co. Long Term Disability Plan, et al., No. 15-15294, 9th Cir., 2017 U.S. App. LEXIS 2753).

  • February 22, 2017

    6th Circuit Finds Disability Coverage Claims Preempted By ERISA

    CINCINNATI — After finding that a former marketing director's claims for coverage against a medical review company were completely preempted by the Employee Retirement Income Security Act, the Sixth Circuit U.S. Court of Appeals on Feb. 17 affirmed dismissal of the claims and found that a previous lawsuit filed against a plan administrator was the proper recourse (James Hackney v. Allmed Healthcare Management Inc., No. 16-5651, 6th Cir., 2017 U.S. App. LEXIS 2877).

  • February 22, 2017

    High Court Denies Cert In Case Over Termination Of Long-Term Benefits

    WASHINGTON, D.C. — The U.S. Supreme Court on Feb. 21 denied a petition for a writ of certiorari in a case in which the 11th Circuit U.S. Court of Appeals said a district court did not err in determining that a disability plan did not wrongfully terminate a claimant’s long-term disability benefits (Elizabeth Jenkins v. Grant Thornton LLP, et al., No. 16-682, U.S. Sup.).

  • February 17, 2017

    Judge Converts Motion To Dismiss, Orders Further Briefing In Bad Faith Suit

    ALBUQUERQUE, N.M. — Unable to determine from the evidence provided whether an insured’s disability benefits plan is governed by the Employee Retirement Income Security Act of 1974 (ERISA), a federal judge in New Mexico on Feb. 14 converted the insurer’s motion to dismiss to a motion for summary judgment and ordered supplemental briefing (Sherry Evans-Carmichael v. Liberty Mutual Group Inc., No. 16-276, D. N.M., 2017 U.S. Dist. LEXIS 20599).

  • February 16, 2017

    Substantial Evidence Supports Plan Denial Of LTD Benefits, Ohio Federal Judge Says

    COLUMBUS, Ohio — The denial of a claim for long-term disability (LTD) benefits was not arbitrary and capricious because the claimant was provided with a fair review procedure and substantial evidence supports the denial of benefits, an Ohio federal judge said Feb. 14 in granting the plan’s motion for judgment on the administrative record (Angela Schofield v. Nationwide Insurance Cos., et al., No. 16-371, S.D. Ohio, 2017 U.S. Dist. LEXIS 20687).