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Mealey's Disability Insurance

  • December 12, 2019

    Disability Insurer Incorrectly Calculated First Day Of Disability, Judge Concludes

    CHICAGO — An Illinois federal judge on Dec. 10 granted a disability claimant’s motion for summary judgment after determining that the disability insurer incorrectly calculated the claimant’s first day of disability and the salary on which his long-term disability (LTD) benefits should be based (Harlan Ten Pas v. The Lincoln National Life Insurance Co., No. 18-3694, N.D. Ill., 2019 U.S. Dist. LEXIS 212284).

  • December 12, 2019

    Disability Plan’s Appeal Dismissed; Order Was Not Appealable, Panel Says

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on Dec. 11 dismissed a disability plan’s appeal for lack of jurisdiction after determining that the district court’s ruling was not a final decision because the merits of the disability claim have yet to be resolved (Sherry Laake v. Benefits Committee, Western & Southern Financial Group Company Flexible Benefits Plan, et al., No. 19-3233, 6th Cir., 2019 U.S. App. LEXIS 36634).

  • December 12, 2019

    Termination Of LTD Benefits Was Not Based On Substantial Evidence

    BALTIMORE — A federal judge in Maryland on Dec. 4 granted a disability claimant’s motion for summary judgment and reinstated the claimant’s benefits after determining that the disability insurer’s termination of long-term disability (LTD) benefits was not based on substantial evidence (Dana Krysztofiak v. Boston Mutual Life Insurance Co., No. 19-0879, D. Md., 2019 U.S. Dist. LEXIS 209452).

  • December 11, 2019

    Plan Did Not Abuse Discretion In Terminating Disability Benefits, Panel Says

    SAN FRANCISCO — A district court did not err in applying an abuse-of-discretion standard of  review in a disability suit because the plan administrator’s conduct did not rise to the level of requiring a de novo review of the plan’s denial of benefits, the Ninth Circuit U.S. Court of Appeals said Dec. 10 in affirming the lower court’s finding that the plan did not abuse its discretion in terminating the disability claimant’s benefits (Olga Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., Nos. 18-15400, 18-16178, 9th Cir., 2019 U.S. App. LEXIS 36542).

  • December 10, 2019

    5th Circuit Affirms Ruling That Disability Insurer Did Not Abuse Its Discretion

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Dec. 6 affirmed a district court’s ruling that a disability insurer did not abuse its discretion in finding that a claimant was not disabled from performing the duties of her own occupation as an attorney because the objective medical evidence clearly supports the insurer’s finding (Anne Wittmann v. Unum Life Insurance Company of America, No. 19-30254, 5th Cir., 2019 U.S. App. LEXIS 36311).

  • December 04, 2019

    Disability Claimant Met Burden Of Proving He Remained Disabled

    SAN FRANCISCO — A California federal judge on Nov. 27 granted a disability claimant’s motion for judgment on the administrative record after determining that the claimant met his burden of proving that he remained disabled from performing the duties of his sedentary occupation as a project manager (Steven S. Garretson v. Metropolitan Life Insurance Co., No. 17-7052, N.D. Calif., 2019 U.S. Dist. LEXIS 206700).

  • November 27, 2019

    Nondisclosure Of Private Health Information Outweighs Public Interest, Judge Says

    COLUMBUS, Ohio — An Ohio federal magistrate judge on Nov. 25 granted a disability insurer’s request to file a plan participant’s claim file under seal because the nondisclosure of the plan participant’s private health information outweighs any public interest in the breach of contract and bad faith suit filed against the disability insurer (Barbara Cluck v. Unum Life Insurance Company of America, No. 18-56, S.D. Ohio, 2019 U.S. Dist. LEXIS 203849).

  • November 26, 2019

    Discovery In Disability Suit Is Not Warranted, California Federal Judge Determines

    OAKLAND, Calif. — A California federal judge on Nov. 25 denied a disability claimant’s request to conduct discovery after determining that the claimant failed to prove that additional evidence is necessary to conduct an adequate de novo review (Natalya Vigdorchik v. Liberty Life Assurance Company of Boston, et al., No. 19-3891, N.D. Calif., 2019 U.S. Dist. LEXIS 204512). 

  • November 26, 2019

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

    COLUMBIA, Tenn. — A Tennessee federal judge on Nov. 22 adopted a magistrate judge’s recommendation that a disability plan’s motion for judgment on the administrative record be granted because the disability plan administrator’s termination of long-term disability (LTD) benefits was not arbitrary and capricious (Danny J. Sexton v. Ohio Valley Electric Corp. et al. No. 18-35, M.D. Tenn., 2019 U.S. Dist. LEXIS 203323).

  • November 25, 2019

    Attorney Fees Awarded To Disability Claimant Based On Success On Merits

    SALT LAKE CITY — A Utah federal judge on Nov. 21 awarded a disability claimant attorney fees after determining that the claimant’s success on the merits of a long-term disability (LTD) benefits claim warrants the award of attorney fees (Don Foust v. Lincoln National Life Insurance Co., No. 17-1208, D. Utah, 2019 U.S. Dist. LEXIS 202915).

  • November 25, 2019

    Disability Claimant Failed To Prove Disability During Elimination Period, Panel Says

    ATLANTA — A disability insurer’s denial of long-term disability benefits was not wrong because the disability claimant failed to prove that he was disabled from his own occupation throughout the entire elimination period as required by the disability policy, the 11th Circuit U.S. Court of Appeals said Nov. 22 in affirming a district court’s judgment in favor of the insurer (Keyton Benson v. Hartford Life and Accident Insurance Co., No. 18-14835, 11th Cir.,  2019 U.S. App. LEXIS 34810).

  • November 25, 2019

    Disability Insurer Did Not Breach Contract Or Act In Bad Faith In Denying Benefits

    SACRAMENTO, Calif. — A disability claimant failed to prove that a disability insurer breached its contract or acted in bad faith in denying any-occupation disability benefits, a California federal judge said Nov. 21 in granting summary judgment in favor of the insurer (Loretta Bruce v. Hartford Life & Accident Insurance Co., No. 17-2201, E.D. Calif., 2019 U.S. Dist. LEXIS 202511).

  • November 21, 2019

    Disability Administrator Abused Discretion In Denying LTD Claim, Panel Says

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on Nov. 19 remanded a long-term disability (LTD) benefits claim to the plan administrator after determining that the plan administrator abused its discretion in denying benefits based on the one-week waiting period required by the plan (Michael Alves v. Hewlett-Packard Comprehensive Welfare Benefits Plan, et al., No. 18-55819, 9th Cir., 2019 U.S. App. LEXIS 34362).

  • November 19, 2019

    Disability Insurer Considered Treating Physicians’ Opinions, Federal Judge Says

    COLUMBUS, Ohio — A disability insurer’s denial of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer considered the opinions of the claimant’s treating physicians in addition to the insurer’s independent reviewers, an Ohio federal judge said Nov. 15 in denying the claimant’s motion for judgment on the administrative record (Daniel M. Wehner v. Standard Insurance Co., No. 18-982, S.D. Ohio, 2019 U.S. Dist. LEXIS 198660).

  • November 18, 2019

    Federal Jurisdiction Does Not Exist; Disability Suit Remanded To State Court

    SAN FRANCISCO — A California federal magistrate judge on Nov. 15 remanded a disability claimant’s suit after determining that diversity of jurisdiction does not exist because a negligence claim asserted against the insurance agency that sold the disability policies to the claimant may not be time-barred under California law (Mark Bennett, D.D.S. v. Ohio National Life Assurance Corp., et al., No. 19-5774, N.D. Calif., 2019 U.S. Dist. LEXIS 198719).

  • November 15, 2019

    Termination Of LTD Benefits Supported By Substantial Evidence

    LAFAYETTE, La. — The termination of a disability plan participant’s long-term disability benefits was not arbitrary and capricious, a Louisiana federal judge said Nov. 12, because the decision to terminate benefits was supported by substantial evidence (Jerry Courville v. Life Insurance Company of North America et al., No. 18-1133, W.D. La., 2019 U.S. Dist. LEXIS 197469).

  • November 15, 2019

    Disability Claimant Files Suit Seeking Past, Future LTD Benefits Under Plan

    ALEXANDRIA, Va. — A disability claimant filed suit Nov. 13 in Virginia federal court seeking a declaration that she is entitled to past and future long-term disability (LTD) benefits under a plan issued by her employer (Amanda Taylor v. Life Insurance Company of North America, No. 19-1443, E.D. Va.).

  • November 13, 2019

    Federal Judge Says NFL Player’s Equitable Estoppel Claim Must Be Dismissed

    TAMPA, Fla. — A Florida federal judge on Nov. 12 dismissed a former National Football League player’s equitable estoppel claim in a suit seeking additional disability benefits after determining that the player failed to prove that the equitable estoppel claim falls into a limited circumstance under the Employee Retirement Income Security Act as set forth by the 11th Circuit U.S. Court of Appeals (Tyrone Keys v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, et al., No. 18-2098, M.D. Fla., 2019 U.S. Dist. LEXIS 195505).

  • November 13, 2019

    Judge Dismisses Disability Plan From Suit Pursuant To Parties’ Stipulation

    SACRAMENTO, Calif. — A California federal judge on Nov. 8 dismissed a long-term disability plan from a disability claimant’s suit seeking long-term disability benefits based on a stipulation submitted to the court by the parties (Lydia Kahler v. Hartford Life & Accident Insurance Co., et al., No. 19-1913, E.D. Calif., 2019 U.S. Dist. LEXIS 195381).

  • November 08, 2019

    Pre-Existing Condition Exclusion Bars LTD Benefits For Drug Dependence

    ATLANTA — A disability insurer’s denial of a long-term disability claim for substance abuse was not arbitrary and capricious because the medical evidence supports the insurer’s finding that the pre-existing condition exclusion applied as a bar to benefits, the 11th Circuit U.S. Court of Appeals said Nov. 7 (Anthony J. Ferrizzi v. Reliance Standard Life Insurance Co., No. 18-11803, 11th Cir., 2019 U.S. App. LEXIS 33350).