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Mealey's Disability Insurance

  • April 03, 2020

    No Abuse Of Discretion In Denying Disability Claims, Magistrate Judge Says

    SAN ANTONIO — A disability insurer did not abuse its discretion in denying short-term disability (STD) and long-term disability (LTD) claims filed by a claimant suffering from anxiety and depression because substantial evidence exists in the administrative record to support the denial of the claims, a Texas federal magistrate judge said April 1 in recommending that the insurer’s motion for summary judgment be granted (Ramon Hernandez v.  Life Insurance Company of North America, et al., No. 19-22, W.D. Texas, 2020 U.S. Dist. LEXIS 56949). 

  • April 02, 2020

    New York Federal Judge Dismisses Former NFL Player’s Disability Suit

    NEW YORK — A New York federal judge on March 31 dismissed a former National Football League player’s amended complaint after determining that the player failed to allege an injury in fact arising out of a claim that the NFL’s retirement plan and its fiduciaries duty violated the Employee Retirement Income Security Act by refusing to reclassify players’ disability benefits as football degenerative (FD) benefits (Christopher Hudson, et al. v. National Football League Management Council, et al., No. 18-4483, S.D. N.Y., 2020 U.S. Dist. LEXIS 57120).

  • April 02, 2020

    Panel Says Further Fact-Finding Necessary To Determine If LTD Benefits Warranted

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on March 31 vacated a district court’s judgment in favor of a disability claimant after determining that further fact-finding is necessary to determine whether the claimant was eligible for long-term disability (LTD) benefits under the  terms of the plan (Cheryl L. Wallace v. Oakwood Healthcare Inc., et al., No. 18-2316, 6th Cir., 2020 U.S. App. LEXIS 10055).

  • April 01, 2020

    6th Circuit Says Disability Plan Administrator Failed To Consider All Evidence

    CINCINNATI — A disability plan administrator’s termination of long-term disability (LTD) benefits was arbitrary and capricious because the plan administrator failed to consider all objective evidence regarding the claimant’s disabling conditions, the majority of the Sixth Circuit U.S. Court of Appeals said March 30 in reversing a district court’s ruling (Teresa Outward v. Eaton Corporation Disability Plan for U.S. Employees, et al., No. 19-3365, 6th Cir., 2020 U.S. App. LEXIS 10098). 

  • April 01, 2020

    Hourly Rate Used To Calculate Disability Claimant’s Attorney Fees Was Reasonable

    NEW YORK — An award of attorney fees based on an hourly rate of $600 for a disability claimant’s attorney was not unreasonable because the hourly rate is consistent with the hourly rate used by other courts in the Southern District of New York, a New York federal judge said March 27 in denying the claimant’s motion for reconsideration (Cherylle McFarlane v. First Unum Life Insurance Co., No. 16-7806, S.D. N.Y., 2020 U.S. Dist. LEXIS 54319).

  • April 01, 2020

    Judge Upholds Order Denying Additional Discovery In Disability Benefits Suit

    TRENTON, N.J. — A magistrate judge did not err in refusing to allow additional discovery in a disability benefits dispute because the magistrate judge’s order was not clearly erroneous or contrary to law, a New Jersey federal judge said March 30 (Kevin McCann, M.D. v. Unum Provident, et al., No. 11-3241, D. N.J., 2020 U.S. Dist. LEXIS 55106).

  • March 31, 2020

    Former Employee Failed To Allege Facts In Support Of Breach Of Fiduciary Duty Claim

    RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals on March 26 affirmed a district court’s ruling on a breach of fiduciary duty claim after determining that the plaintiff failed to prove that her former employer made any material misrepresentations about her access to disability and health insurance benefits included as part of her severance package (Michele Damiano v. Institute for In Vitro Sciences et al., No. 18-2382, 4th Cir., 2020 U.S. App. LEXIS 9468).

  • March 27, 2020

    Treating Physician Did Not Find Claimant Was Disabled From Duties Of Own Occupation

    AUGUSTA, Ga. — A disability plan administrator’s termination of long-term disability (LTD) benefits was not wrong or unreasonable because the disability claimant’s treating physician did  not find that the claimant was unable to perform the duties of her own occupation on a continual basis, a Georgia federal judge said March 26 (Diana P. Harris v. Savannah River Remediation Disability Short & Long Term Disability Plan, No. 18-152, S.D. Ga., 2020 U.S. Dist. LEXIS 52808).

  • March 27, 2020

    Termination Of LTD Benefits Was Not Arbitrary, Capricious, Federal Judge Says

    PEORIA, Ill. — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s decision to discontinue the claimant’s benefits was not “downright unreasonable,” an Illinois federal judge said March 25 in granting the insurer’s motion for judgment on the pleadings (Arthur F. Feeney v. Unum Life Insurance Company of America, No. 18-1302, C.D. Ill., 2020 U.S. Dist. LEXIS 51356).

  • March 26, 2020

    Claimant Is Entitled To LTD Benefits Under Own-Occupation Standard, Judge Says

    SAN FRANCISCO — A California federal judge on March 24 granted a disability claimant’s motion for judgment on the administrative record after determining that the medical evidence supports a finding that the claimant is entitled to long-term disability (LTD) benefits under the disability plan’s own-occupation standard (Anis Shaikh v. Aetna Life Insurance Co., No. 18-4394, N.D. Calif., 2020 U.S. Dist. LEXIS 51897).

  • March 25, 2020

    Disability Claimant Entitled To Benefits, California Federal Judge Says

    SACRAMENTO,  Calif. — A California federal judge on March 24 determined that a disability claimant is entitled to long-term disability (LTD) benefits under the plan’s own-occupation standard and remanded the claim to the plan administrator to determine if the claimant is disabled from performing the duties of any gainful occupation (Renee Johnson Monroe v. Metropolitan Life Insurance Co., No. 15-2079, E.D. Calif., 2020 U.S. Dist. LEXIS 51075).

  • March 24, 2020

    Substantial Evidence Supports Disability Insurer’s Termination Of LTD Benefits

    WHITE PLAINS, N.Y. — A New York federal judge on March 20 granted a disability insurer’s motion for summary judgment after determining that substantial evidence supported the disability  insurer’s termination of long-term disability (LTD) benefits after paying the claimant benefits for six years (Joseph J. Hinchey v. First Unum Life Insurance Co. et al., No. 17-08034, S.D. N.Y., 2020 U.S. Dist. LEXIS 49703).

  • March 18, 2020

    9th Circuit Finds No Error In District Court’s Judgment For Disability Insurer

    PASADENA, Calif. — A district court did not err in entering judgment for a disability insurer following a bench trial because the disability insurer’s termination of benefits is supported by the medical evidence, the Ninth Circuit U.S. Court of Appeals said March 17 (Lonny R. Western v. Unum Life Insurance Company of America, No. 18-56039, 9th Cir., 2020 U.S. App. LEXIS 8362).

  • March 18, 2020

    Jury Verdict For Disability Claimant Was Reasonable, Panel Says In Affirming

    DENVER — The 10th Circuit U.S. Court of Appeals on March 17 affirmed a jury verdict in favor of a disability claimant after determining that based on the policy language, it was reasonable for the jury to conclude that the claimant was entitled to disability benefits (Brenda Sandoval v. Unum Life Insurance Company of America, Nos. 19-1047, 19-1164, 10th Cir., 2020 U.S. App. LEXIS 8398).

  • March 17, 2020

    LTD Insurer’s Termination Of Benefits Supported By Substantial Evidence

    BOSTON — A Massachusetts federal judge on March 12 granted a disability insurer’s motion for summary judgment after determining that the insurer’s decision to terminate a claimant’s long-term disability benefits was reasonable because substantial evidence supports the insurer’s finding that the claimant was psychologically, but not physically, disabled from working (Karen Gammon v. Reliance Standard Life Insurance Co., No. 18-11665, D. Mass., 2020 U.S. Dist. LEXIS 43022).

  • March 17, 2020

    Denial Of LTD Claim Was Reasonable Based On Pre-Existing Condition

    COLUMBUS, Ohio — A disability insurer’s denial of a long-term disability (LTD) benefits claim based on the plan’s pre-existing condition exclusion was proper because the medical records support the conclusion that the claimant’s inability to work was caused by a pre-existing condition, an Ohio federal judge said March 3 in granting a disability insurer’s motion for judgment on the administrative record (Angela Harrison v. Life Insurance Company of North America, No. 18-1077, S.D. Ohio, 2020 U.S. Dist. LEXIS 36932).

  • March 11, 2020

    LTD Claim Remanded; Plan Administrator Did Not Consider Psychiatric Conditions

    SAN FRANCISCO — A California federal judge on March 6 remanded a disability plan participant’s long-term disability (LTD) claim to the plan administrator after determining that the plan administrator failed to consider the claimant’s psychiatric conditions before terminating her LTD benefits (Lisa Schwarz v. Hartford Life & Accident Insurance Co., No. 19-2370, N.D. Calif., 2020 U.S. Dist. LEXIS 39581).

  • March 11, 2020

    Insurance Agent’s Declaration Excluded From Administrative Record In Disability Suit

    NEW ORLEANS — A Louisiana federal judge on March 6 determined that the declaration of an insurance agent cannot be considered by the court in a long-term disability (LTD) benefits dispute because the agent’s declaration was not made available to the disability insurer before the disability claimant filed suit (Michael G. Miller v. Reliance Standard Insurance Co., No. 18-10028, E.D. La., 2020 U.S. Dist. LEXIS 39005).

  • March 05, 2020

    Limited Discovery Allowed On Dual-Role Conflict Of Interest In Disability Case

    TOPEKA, Kan. — A federal magistrate judge in Kansas on Feb. 28 granted a disability claimant’s motion for discovery to determine whether her insurer’s dual role as plan administrator and payer affected its decision to deny her long-term disability (LTD) benefits, finding that the claimant met her burden to prove that limited discovery on the issue is appropriate (Jodie L. Bribiesca v. Metropolitan Life Insurance Company, No. 19-1339, D. Kan., 2020 U.S. Dist. LEXIS 34929).

  • March 05, 2020

    De Novo Standard Of Review Applies Where Disability Insurer Violated New DOL Regs

    MOBILE, Ala. — A federal judge in Alabama on Feb. 26 denied a motion to reconsider a ruling that a de novo standard of review applied in a dispute over the termination of disability benefits because recent amendments to the Department of Labor (DOL) regulations requiring the insurer to provide the claimant with new evidence that the denial on review was based on governed the claim (Brian McConnell v. American General Life Insurance Co., No. 19-0174, S.D. Ala., 2020 U.S. Dist. LEXIS 32724).