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Mealey's Disability Insurance

  • August 14, 2018

    Claimant Entitled To STD Benefits Under Plan, 10th Circuit Panel Affirms

    DENVER — The 10th Circuit U.S. Court of Appeals on Aug. 13 affirmed a district court’s ruling in favor of a disability claimant after determining that the claimant was entitled to short-term disability benefits under his company’s disability plan because the record does not contain substantial evidence showing that the claimant was capable of performing the duties of his job (Kevin McMillan v. AT&T Umbrella Benefit Plan No. 1, No. 17-5111, 10th Cir., 2018 U.S. App. LEXIS 22366).

  • August 9, 2018

    Disability Insurer’s Denial Of Benefits Was Reasonable, Federal Judge Says

    BALTIMORE — A disability insurer did not abuse its discretion in denying a plan participant’s long-term disability benefits claim because the evidence shows that the denial was reasonable and was made after a fair review was conducted, a Maryland federal judge said Aug. 7 (Karin Reidy v. Unum Life Insurance Company of America, No. 16-2926, D. Md., 2018 U.S. Dist. LEXIS 133287).

  • August 9, 2018

    Federal Judge Dismisses Disability Complaint, Says It Is A Shotgun Pleading

    FORT MYERS, Fla. — A Florida federal judge on Aug. 8 dismissed a disability claimant’s complaint with leave to amend after determining that the complaint is a shotgun pleading in violation of Rule 8 of the Federal Rules of Civil Procedure because the complaint includes numerous irrelevant and unnecessary details (Marcus Allen, M.D. v. First Unum Life Insurance Co., et al., No. 18-69, M.D. Fla., 2018 U.S. Dist. LEXIS 133160).

  • August 8, 2018

    Federal Judge Grants Parties’ Joint Motion To Dismiss Disability Benefits Suit

    SACRAMENTO, Calif. — A California federal judge on Aug. 6 dismissed a disability claimant’s suit with prejudice following the parties’ filing of a joint stipulation for dismissal (Brenda Culbertson-Chavira v. Life Insurance Company of North America, No. 17-1702, E.D. Calif., 2018 U.S. Dist. LEXIS 132014).

  • August 7, 2018

    High Court Should Review 9th Circuit’s Offset Ruling, Disability Claimant Says

    WASHINGTON, D.C. — The U.S. Supreme Court should grant review of a disability claimant’s petition for writ of certiorari in a dispute over the offsetting of a claimant’s long-term disability (LTD) benefits to account for Social Security disability income (SSDI) benefits received on behalf of the claimant’s dependents because the plan administrators did not apply the language of the LTD plan as written, the claimant says in a June 22 reply brief (Susan Rene Jones v. Merck Sharpe & Dohme Corp., et al., No. 17-1478, U.S. Sup.).

  • August 6, 2018

    High Court’s Review Of Service-Of-Suit Ruling Is Not Warranted, Respondents Say

    WASHINGTON, D.C. — The U.S. Supreme Court should deny a petition for writ of certiorari because the Colorado Supreme Court’s dismissal of two long-term disability insurance lawsuits based on the failure to serve the proper parties was the proper decision and there is no conflict between federal courts of appeal regarding whether a benefit plan governed by the Employee Retirement Income Security Act is a proper defendant, the respondents argue in a July 25 brief (Brenda Olivar v. Public Service Employee Credit Union Long Term Disability Plan, and Caroline Burton, et al. v. Colorado Access, et al., No. 17-1543, U.S. Sup.).

  • August 6, 2018

    Disability Claimant Failed To Exhaust All Administrative Remedies, Judge Says

    CONCORD, N.H. — A New Hampshire federal judge on July 23 granted judgment in favor of a disability plan and against a disability claimant after determining that the claimant did not exhaust all administrative remedies before filing suit because she did not timely appeal the insurer’s termination of disability benefits (Theresa Fortier v. Hartford Life and Accident Insurance Co., No. 16-322, D. N.H., 2018 U.S. Dist. LEXIS 126345).

  • August 6, 2018

    Denial Of Disability Benefits Supported By Substantial Evidence, Panel Says

    ATLANTA — A district court did not err in entering judgment in favor of a disability insurer because the insurer’s denial of any-occupation benefits was supported by substantial evidence and the court did not commit “plain error” in finding for the insurer, the 11th Circuit U.S. Court of Appeals said Aug. 3 (Antonio Lopez v. Standard Insurance Co., No. 17-11012, 11th Cir., 2018 U.S. App. LEXIS 21525).

  • August 6, 2018

    5th Circuit Finds Termination Of Disability Benefits Was Reasonable

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Aug. 3 determined that a district court did not err in concluding that substantial evidence supports a disability insurer’s termination of benefits based on the plan’s 24-month limitation for mental disorders (Ricky D. Hayes v. Dearborn National Life Insurance Co., No. 17-30670, 5th Cir., 2018 U.S. App. LEXIS 21608).

  • August 1, 2018

    Disability Claimant Received Full And Fair Review, 4th Circuit Panel Says

    RICHMOND, Va. — A disability insurer did not abuse its discretion in terminating a claimant’s disability benefits because the record shows that the claimant received a full and fair review of his claim, the Fourth Circuit U.S. Court of Appeals said July 31 (Scott Griffin v. Hartford Life & Accident Insurance Co., No. 17-1251, 4th Cir., 2018 U.S. App. LEXIS 21166).

  • July 31, 2018

    Claimant Entitled To LTD Benefits For West Nile Virus, Judge Says

    DENVER — A disability claimant is entitled to past and future long-term disability benefits because the insurer’s termination of benefits was an abuse of discretion because the weight of the evidence supported a finding that the claimant was disabled as a result of West Nile virus, a Colorado federal judge said July 26 (Michael J. Paquin v. Prudential Insurance Company of America, No. 16-02142, D. Colo., 2018 U.S. Dist. LEXIS 125231).

  • July 26, 2018

    Federal Magistrate Judge Says Compensation Paid To Reviewing Doctor Is Relevant

    NEW ORLEANS — A Louisiana federal magistrate judge on July 11 partially denied a disability insurer’s motion to quash a subpoena seeking compensation records from a physician hired by the insurer to review a disability claimant’s file after determining that the discovery sought is relevant and permitted under the Employee Retirement Income Security Act (Anne Wittmann v. Unum Life Insurance Company of America, No. 17-9501, E.D. La., 2018 U.S. Dist. LEXIS 115848).

  • July 26, 2018

    Disability Claimant Not Entitled To Attorney Fees, Michigan Federal Judge Says

    CINCINNATI — A disability claimant is not entitled to an award for attorney fees and costs because the plan administrator’s conduct in failing to schedule an in-person medical exam does not suggest a high level of culpability, a Michigan federal judge said July 17 (Kimberly J. Guest-Marcotte v. Life Insurance Company of North America, et al., No. 15-10738, E.D. Mich., 2018 U.S. App. LEXIS 8105).

  • July 26, 2018

    Motion For Attorney Fees Denied; Court Made No Ruling On Merits Of Disability Claim

    SACRAMENTO, Calif. — A disability claimant is not entitled to attorney fees and costs because she did not achieve success in an “action” under the Employee Retirement Income Security Act’s attorney fee provision, a California federal judge said July 23, noting that the court did not rule on any substantive motions of the merits in the suit (Brenda Culbertson-Chavira v. Life Insurance Company of North America, No. 17-1702, E.D. Calif., 2018 U.S. Dist. LEXIS 122872).

  • July 25, 2018

    Insurer’s Termination Of Disability Benefits Was Reasonable Based On Evidence

    SACRAMENTO, Calif. — A disability insurer did not act in bad faith in terminating an insured’s benefits, a federal judge in California said July 23 after determining that based on the insured’s misrepresentations about her ability to work, the insurer had a reasonable basis to terminate the benefits (Devra Bommarito v. The Northwestern Mutual Life Insurance Co., et al., No. 15-1187, E.D. Calif., 2018 U.S. Dist. LEXIS 122853).

  • July 17, 2018

    LTD Insurer Wrongfully Applied Pre-Existing Condition Exclusion, Insured Says

    NEW YORK — A disability insurer wrongfully denied a claim for long-term disability (LTD) benefits based on the plan’s pre-existing condition exclusion because the claimant’s diagnosis of attention deficit hyperactivity disorder during the 90-day period prior to becoming insured was not a misdiagnosis of the claimant’s later diagnosis of bipolar disorder, the condition for which LTD benefits were sought, the claimant says in a July 2 complaint filed in New York federal court (Aaron Slavutin v. Standard Insurance Co., No. 18-5994, S.D. N.Y.).

  • July 11, 2018

    Disability Claimant’s Suit Was Properly Dismissed, 6th Circuit Panel Says

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on July 9 affirmed the dismissal of a disability claimant’s suit after determining that the claimant failed to provide support for the state law claims that were not preempted under the Employee Retirement Income Security Act (Surrinder Arora v. Henry Ford Health System, et al., No. 17-2252, 6th Cir., 2018 U.S. App. LEXIS 18712).

  • July 11, 2018

    Panel Vacates, Remands Disability Award For Recalculation Of Benefits

    ATLANTA — A district court did not err in determining that a disability claimant abandoned his bad faith claims against a disability insurer, but  the court did err in interpreting the disability insurer’s continuity of coverage policy provision, the 11th U.S. Court of Appeals said July 10 in vacating and remanding an award of benefits for recalculation (Wayne Torpy v. Unum Life Insurance Company of America, No. 17-14722, 11th Cir., 2018 U.S. App. LEXIS 18669).

  • July 6, 2018

    Professional Hockey Player’s Claims Preempted Under ERISA, Federal Judge Says

    DALLAS —  A Texas federal judge on June 20 granted a disability insurer’s motion to dismiss after determining that a former professional hockey player’s claims are preempted under the Employee Retirement Income Security Act (Aaron Rome v. HCC Life Insurance Co., No. 16-2480, N.D. Texas, 2018 U.S. Dist. LEXIS 102962).

  • July 6, 2018

    9th Circuit Panel Refuses To Rehear Arguments In Disability Benefits Suit

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on July 3 denied a petition for rehearing, refusing to reconsider a June 15 remand of a disability benefits dispute to a district court to determine whether the claimant is entitled to equitable relief based on the disability plan’s failure to properly offset the claimant’s disability benefits (Petar Mrkonjic v. Delta Family-Care and Survivorship Plan, et al., Nos. 16-56335 and 16-56487, 9th Cir., 2018 U.S. App. LEXIS 18228).