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Mealey's Disability Insurance

  • April 9, 2019

    Bench Trial To Be Held In Long-Term Disability Benefits Dispute

    ROCHESTER, N.Y. — A New York federal judge on April 5 adopted a magistrate judge’s recommendation that a bench trial be scheduled in a disability benefits dispute because issues of fact exist regarding the claimant’s ability to perform the duties of his own occupation (Farooq Khan v. Provident Life & Accident Co., No. 15-811, W.D. N.Y., 2019 U.S. Dist. LEXIS 59204).

  • April 8, 2019

    Bench Trial To Be Held In Long-Term Disability Benefits Dispute

    ROCHESTER, N.Y. — A New York federal judge on April 5 adopted a magistrate judge’s recommendation that a bench trial be scheduled in a disability benefits dispute because issues of fact exist regarding the claimant’s ability to perform the duties of his own occupation (Farooq Khan v. Provident Life & Accident Co., No. 15-811, W.D. N.Y., 2019 U.S. Dist. LEXIS 59204).

  • April 5, 2019

    Denial Of Attorney Fees In Disability Suit Must Be Reversed, Panel Majority Says

    CINCINNATI — A district court erred in denying a disability claimant’s request for attorney fees because the disability insurer’s decision-making process in denying benefits was not legally supported, the majority of the Sixth Circuit U.S. Court of Appeals said April 1 in reversing the lower court’s ruling (Kimberly J. Guest-Marcotte v. Life Insurance Company of North America, et al., No. 18-1948, 6th Cir., 2019 U.S. App. LEXIS 9481).

  • April 5, 2019

    Disability Claimant Entitled To Increased Monthly Benefits Under Plan, Panel Says

    DENVER — A disability insurer incorrectly classified a disability claimant’s employment position with a pharmaceutical company, the 10th Circuit U.S. Court of Appeals said April 2 after determining that the evidence supports a district court’s conclusion that the claimant’s position qualified as a sales position under the plan, entitling the claimant to an increased amount of monthly disability benefits (Lou Hodges v. Life Insurance Company of North America, No. 18-1279, 10th Cir., 2019 U.S. App. LEXIS 9601).

  • April 2, 2019

    Panel Says Denial Of LTD Benefits Was Reasonable Based On Evidence

    BOSTON — A disability plan did not act arbitrarily and capriciously in denying a claim for long-term disability (LTD) benefits because the plan’s decision to deny the claim after determining that the claimant was not physically disabled from performing the duties of his sedentary occupation was reasonable and supported by the evidence, the First Circuit U.S. Court of Appeals said March 29 (Dionisio Santana-Díaz v. Metropolitan Life Insurance Co., No. 17-1428, 1st Cir., 2019 U.S. App. LEXIS 9368).

  • April 1, 2019

    Denial Of Short-Term Disability Benefits Was Not An Abuse Of Discretion

    GREENSBORO, N.C. — A disability plan claims administrator did not abuse its discretion in denying a claimant’s short-term disability (STD) benefits claim, a North Carolina federal judge said March 28 after determining that the claims administrator’s decision was supported by substantial evidence (Eric Jones v. Charter Communications Short Term Disability Plan, No. 17-863, M.D. N.C., 2019 U.S. Dist. LEXIS 52345).

  • March 29, 2019

    Disability Claimant Permitted To Allege Breach Of Contract Claim Under Alabama Law

    INDIANAPOLIS — A disability claimant is permitted to file an amended complaint to allege a breach of contract claim under Alabama law against a disability income insurer, an Indiana federal judge said March 28 after determining that Alabama law must be applied to the disability benefits dispute (Chad E. Mathis, M.D. v. Metropolitan Life Insurance Co., a/k/a MetLife, et al., No. 18-1893, S.D. Ind., 2019 U.S. Dist. LEXIS 52703).

  • March 29, 2019

    Disability Insurer’s Denial Of Benefits Was Not Abuse Of Discretion, Judge Says

    HUNTINGTON, W.Va. — A disability insurer did not abuse its discretion in denying a long-term disability (LTD) benefits claim because the insurer considered all of the medical evidence and consulted with two physicians before denying the claim, a West Virginia federal judge said March 27 (Genka Popov v. University Physicians & Surgeons Inc. Long Term Disability Plan, et al., No. 18-296, S.D. W.Va., 2019 U.S. Dist. LEXIS 51685).

  • March 27, 2019

    Termination Of LTD Benefits Was Not Abuse Of Discretion, Maryland Federal Judge Says

    BALTIMORE — A disability insurer’s termination of long-term disability (LTD) benefits was not an abuse of discretion, a Maryland federal judge said March 25, noting that substantial evidence supported the insurer’s termination (Rosalyn Irving v. The Unum Life Insurance Company of America, No. 17-3206, D. Md., 2019 U.S. Dist. LEXIS 49261).

  • March 26, 2019

    Reconsideration Denied; Ruling In Disability Insurer’s Favor Stands

    PHOENIX — Reconsideration of a ruling that a disability insurer did not breach its contract or act in bad faith by denying a claim for benefits is not warranted, an Arizona federal judge said March 25 in rejecting the claimant’s argument that reconsideration is justified because the disability insurer did not accurately state the disability onset date (Cynthia Cheney v. United States Life Insurance Company in the City of New York, et al., No. 17-0004, D. Ariz., 2019 U.S. Dist. LEXIS 14742).

  • March 22, 2019

    Termination Of LTD Benefits Was Arbitrary, Capricious, Judge Concludes

    ANN ARBOR, Mich. — A disability insurer’s termination of  long-term disability (LTD) benefits was arbitrary and capricious because the insurer improperly ignored favorable evidence submitted by the claimant’s treating physicians and selectively reviewed the medical evidence, a Michigan federal judge said March 20 (Christopher Carr v. Metropolitan  Life Insurance Co., No. 17-14101,  E.D. Mich., 2019 U.S. Dist. LEXIS 45421).

  • March 22, 2019

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

    PITTSBURGH — A Pennsylvania federal magistrate judge on March 15 recommended denying a disability claimant’s motion for summary judgment and granting the defendants’ motion for summary judgment because the decision to terminate the claimant’s disability benefits was not arbitrary and capricious (Gregory Addington v. Senior Vice President Human Resources Consol Energy Inc. et al., No. 17-444, W.D. Pa., 2019 U.S. Dist. LEXIS 43830).

  • March 21, 2019

    Termination Of Disability Benefits Was Proper; Claimant Failed To Provide Information

    LOUISVILLE, Ky. — A Kentucky federal judge on March 20 denied a disability claimant’s motion for judgment on the administrative record after determining that the disability insurer conducted a full and fair review and that the insurer was entitled to terminate the claimant’s benefits after the claimant failed to comply with its request for additional information (Emmanuel J. Quarles v. Hartford Life & Accident Insurance Co., No. 15-372, W.D. Ky., 2019 U.S. Dist. LEXIS 45908).

  • March 20, 2019

    Termination Of Disability Benefits Was Not Arbitrary And Capricious, Judge Says

    SAVANNAH, Ga. — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the medical evidence supports the insurer’s conclusion that the claimant is not disabled from working in any gainful occupation, a Georgia federal judge said March 18 (Michelle Lord v. American General Life Insurance Company of Delaware, No. 17-167, S.D. Ga., 2019 U.S. Dist. LEXIS 43992).

  • March 19, 2019

    Termination Of Disability Benefits Was Improper Based On Claimant’s Restrictions

    RIVERSIDE, Calif. — A disability insurer’s termination of long-term disability (LTD) benefits was improper because the evidence shows that the claimant could not type for more than 60 minutes a day and her usual occupation required five to six hours of typing per day, a California federal judge said March 11 in entering judgment in favor of the claimant (Jennett Harlow v. Metropolitan Life Insurance Co., et al., No. 17-2091, C.D. Calif., 2019 U.S. Dist. LEXIS 40890).

  • March 19, 2019

    Ample Evidence Supports Denial Of LTD Benefits Under Any-Occupation Standard

    SAN FRANCISCO — A district court did not err in finding that a disability insurer’s denial of disability benefits under a plan’s any-occupation standard was justified because ample evidence in the record supports the insurer’s determination, the Ninth Circuit U.S. Court of Appeals said March 15 (Susan Beach v. Liberty Life Assurance Company of Boston, No. 17-16492, 9th  Cir., 2019 U.S. App. LEXIS 7817).

  • March 18, 2019

    Panel Affirms Disability Plan’s Denial Of Benefits; Decision Was Reasonable

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on March 14 affirmed a district court’s finding that a disability plan’s denial of a claim for disability benefits was reasonable based on the medical evidence and the plan’s use of outside medical experts to evaluate the claim (Joseph Reinwand v. National Electrical Benefit Fund, et al., No. 18-2601, 7th Cir., 2019 U.S. App. LEXIS 7492).

  • March 18, 2019

    Denial Of STD Claim Was Not Unreasonable, Missouri Federal Judge Determines

    ST. LOUIS — The denial of a claim for short-term disability (STD) benefits was not unreasonable based on the evidence in the administrative record and based on the fact that the claimant’s treating physicians could not reach a consensus regarding the claimant’s functional capacity, a Missouri federal judge said March 14 (Jacqueline E. Presi v. Ascension Health Alliance, et al., No. 16-1857, E.D. Mo., 2019 U.S. Dist. LEXIS 41369).

  • March 14, 2019

    Federal Judge Says Bench Trial Is Necessary To Resolve Disability Benefits Dispute

    BALTIMORE — A Maryland federal judge on March 12 denied motions for summary judgment filed by both the plaintiff and defendant after determining that a bench trial is necessary before deciding whether a disability claimant is owed long-term disability (LTD) benefits under the plan’s any-occupation standard (Pamela Mantica v. Unum Life Insurance Company of America, No. 18-0632, D. Md., 2019 U.S. Dist. LEXIS 40007).

  • March 14, 2019

    Woman Sentenced To 21 Months For Illegally Obtaining Disability Benefits

    TAMPA, Fla. — A federal judge in Florida on March 8 sentenced a woman to 21 months in prison and ordered her to pay restitution for illegally obtaining Social Security disability benefits while simultaneously working at a law firm as a title closer (United States v. Roselle Fitzgerald, No. 18cr227, M.D. Fla.).

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