Mealey's Disability Insurance

  • November 20, 2020

    Disability Insurer’s Benefits Termination Supported By Substantial Evidence

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on Nov. 19 affirmed a district court’s ruling that a disability insurer did not act arbitrarily or capriciously in terminating a claimant’s long-term disability (LTD) benefits based on its finding that the claimant was not disabled from working in any occupation because the substantial evidence supports the insurer’s determination (Richard E. Davis v. Hartford Life & Accident Insurance Co., No. 19-6091, 6th Cir., 2020 U.S. App. LEXIS 36360).

  • November 17, 2020

    Disability Plan Permitted To Add Additional Documents To Administrative Record

    STATESVILLE, N.C. — A North Carolina federal judge on Nov. 16 granted a disability plan’s motion to modify the administrative record to add documents pertaining to a plan amendment after determining that the claimant will not be prejudiced by the addition of the documents (Diane Skinder v. Federal Express Long Term Disability Plan, No. 19-153, W.D. N.C., 2020 U.S. Dist. LEXIS 214061).

  • November 16, 2020

    Bad Faith Claim Against Disability Insurer Barred By 2-Year Statute Of Limitations

    LOS ANGELES — A California federal judge on Sept. 16 granted a disability insurer’s motion to dismiss a bad faith claim after determining that the claim is barred by the applicable two-year statute of limitations (Beth L. Vitug v. AXA Equitable Life Insurance Co., et al., No. 20-5492, C.D. Calif., 2020 U.S. Dist. LEXIS 208783).

  • November 13, 2020

    Disability Plan’s Preexisting Condition Limitation Applies, Federal Judge Determines

    MINNEAPOLIS — A Minnesota federal judge on Nov. 12 determined that the denial of a long-term disability (LTD) benefits claim was reasonable based on the disability plan’s preexisting condition limitation provision because the evidence supports the claims administrator’s finding that the claimant was treated for a preexisting condition and not a new disabling condition (Bridget Gross v. Eaton Corp., No. 20-377, D. Minn., 2020 U.S. Dist. LEXIS 211409).

  • November 12, 2020

    Disability Benefits Ruling Modified To Correct End Date Of Benefits Owed

    LOS ANGELES — A California federal judge on Nov. 9 granted a stipulation to modify a ruling entered in favor of a disability claimant because the ruling failed to account for the disability plan’s 60-day waiting period in the calculation of the end date on which long-term disability (LTD) benefits must be paid (Joel Groch v. Dearborn National Life Insurance Co., No. 18-6614, C.D. Calif., 2020 U.S. Dist. LEXIS 209570).

  • November 10, 2020

    Disability Claimant Failed To Prove Disability Under Terms Of Plan, Judge Says

    SAN DIEGO — A disability claimant failed to prove by a preponderance of the evidence that he was disabled under the terms of his disability plan, a California federal judge said Nov. 6 in granting the disability insurer’s motion for judgment and in denying the claimant’s motion for judgment (Brian Joseph Driscoll v. MetLife Insurance, et al., No. 15-1162, S.D. Calif., 2020 U.S. Dist. LEXIS 208846).

  • November 09, 2020

    6th Circuit Won’t Direct Lower Court To Permit Jury Trial Amendment In ERISA Case

    CINCINNATI — A Sixth Circuit U.S. Court of Appeals on Oct. 30 denied a petition for a writ of mandamus filed by a former disability benefits recipient seeking to amend his complaint challenging the discontinuation of his benefits to add a jury demand, finding that “his right to relief is not ‘clear and indisputable’” (In re:  David R. Caudill, No. 20-3834, 6th Cir., 2020 U.S. App. LEXIS 34464).

  • November 06, 2020

    Additional Discovery Will Not Benefit Court In Review Of Termination Of Benefits

    PHOENIX — Additional discovery in a disability benefits dispute is not warranted because additional discovery will not aid the court in its de novo review of the disability insurer’s decision to terminate the claimant’s benefits under the plan’s any-occupation standard, an Arizona federal judge said Oct. 21 (Sherry Hasslacher v. Life Insurance Company of North America, No. 19-5272, D. Ariz., 2020 U.S. Dist. LEXIS 201190).

  • November 06, 2020

    Disability Claimant Not Precluded From Asserting Breach Of Contract Claim

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on Nov. 4 reversed and remanded a district court’s ruling in favor of a disability insurer on breach of contract and bad faith claims after determining that the disability claimant was not precluded from asserting a breach of contract claim based on a prior ruling by the Sixth Circuit (James H. Pogue v. Principal Life Insurance Co., No. 20-5133, 6th Cir., 2020 U.S. App. LEXIS 34937).

  • November 03, 2020

    Additional Disability Benefits Owed Under Disability Plan, Federal Judge Says                            

    LOS ANGELES — A disability insurer’s termination of a long-term disability (LTD) benefits claim is not supported by the medical evidence, a California federal judge said Oct. 29 in determining that the insurer must pay the claimant additional benefits under the disability plan (Joel Groch v. Dearborn National Life Insurance Co., No. 18-6614, C.D. Calif., 2020 U.S. Dist. LEXIS 204171).

  • November 03, 2020

    Magistrate Judge Says Disability Insurer Must Produce Unredacted Documents

    COLUMBUS, Ohio — An Ohio federal magistrate judge on Nov. 2 determined that a disability insurer must produce unredacted copies of information related to disability claims because the information is relevant to a disability plan participant’s claim (Barbara Cluck v. Unum Life Insurance Company of America, No. 18-56, S.D. Ohio, 2020 U.S. Dist. LEXIS 204429).

  • November 02, 2020

    Insurer’s Termination Of Benefits Supported By Evidence, Judge Determines

    SANTA ANA, Calif. — A disability insurer did not wrongfully terminate a disability claimant’s benefits after 17 years because the medical evidence, the claimant’s Facebook posts and the insurer’s investigative reports support the insurer’s conclusion that the claimant was no longer disabled from performing the duties of her own occupation, a California federal judge said Oct. 28 (Michele Reed McCoy v. Aetna Life Insurance Co., et al., No. 19-575, C.D. Calif., 2020 U.S. Dist. LEXIS 202032).

  • October 27, 2020

    Issues Of Fact Exist On Regular Occupation Of Disability Claimant

    ANNISTON, Ala. — An Alabama federal court on Oct. 26 determined that genuine issues of material fact exist as to what a disability claimant’s regular occupation was when he became disabled and whether the claimant’s hand tremors prevented him from performing the duties of his regular occupation (William A. Lemons Jr., M.D. v. Principal Life Insurance Co., No. 18-1040, N.D. Ala., 2020 U.S. Dist. LEXIS 198554).

  • October 27, 2020

    Higher Degree Of Skepticism Must Be Applied To Disability Insurer’s Decision

    PORTLAND, Ore. — The Ninth Circuit U.S. Court of Appeals on Oct. 26 reversed and remanded a district court’s ruling in favor of a disability insurer after determining that the lower court should have applied a “higher degree of skepticism” based on the conflicting medical evidence and the disability insurer’s structural conflict of interest as both the claims administrator and payer (Alison Gary v. Unum Life Insurance Company of America, No. 19-35439, 9th Cir., 2020 U.S. App. LEXIS 33636).

  • October 27, 2020

    Judge:  Additional Discovery In Disability Benefits Dispute Is Not Warranted

    ST. LOUIS — A Missouri federal judge on Oct. 23 denied a disability claimant’s request to depose a claims administrator’s employee and corporate representative regarding the denial of a short-term disability (STD) benefits claim because the claimant failed to provide good cause for conducting the depositions (Kevin Nauss v. Sedgwick Claims Management Services Inc., No. 20-304, E.D. Mo., 2020 U.S. Dist. LEXIS 197491).

  • October 26, 2020

    Insurer’s Termination Of Disability Benefits Was Reasonable, Judge Determines

    ABERDEEN, Miss. — A disability insurer did not abuse its discretion in terminating a claimant’s long-term disability (LTD) benefits under the plan’s any-reasonable-occupation standard because the termination of benefits was reasonable based on the medical evidence, a Mississippi federal judge said Oct. 23 (Jeffrey E. Crump v. Aetna Inc., No. 19-109, N.D. Miss., 2020 U.S. Dist. LEXIS 197375).

  • October 26, 2020

    Disability Insurer Must Produce Documents Related To Training Guidelines

    NEW YORK — A disability insurer must produce documents pertaining to its training guidelines that are applicable to the denial of a disability claimant’s long-term disability (LTD) benefits claim, a New York federal judge said Oct. 21 in partially granting the claimant’s motion to compel (David Smith v. First Unum Life Insurance, et al., No. 19-298, S.D. N.Y., 2020 U.S. Dist. LEXIS 196394).

  • October 22, 2020

    Disability Claimant Failed To Exhaust Administrative Remedies, Panel Says

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Oct. 21 affirmed a district court’s ruling that a disability claimant’s suit must be dismissed for failure to exhaust all administrative remedies because the claimant clearly failed to timely file an administrative appeal of the insurer’s termination of her long-term disability (LTD) benefits claim (Patricia D. White v. Anthem Life Insurance Co., No. 19-16954, 9th Cir., 2020 U.S. App. LEXIS 33213).

  • October 20, 2020

    Disability Claimant Awarded Attorney Fees; Judgment Stayed To Allow Insurer’s Appeal

    DALLAS — A Texas federal judge on Oct. 19 awarded a disability claimant more than $84,000 in attorney fees after determining that the award is warranted based on the claimant’s success on the merits; however, the judge allowed the insurer to post a bond and stayed the execution of the judgment to permit the insurer to file an appeal (Jose Chavez v. Standard Insurance Co., No. 18-2013, N.D. Texas, 2020 U.S. Dist. LEXIS 192877).

  • October 19, 2020

    Federal Judge Grants Stipulation To File Disability Record Under Seal

    TACOMA, Wash. — A Washington federal judge on Oct. 16 granted a joint stipulation to file the administrative record in a disability dispute under seal, agreeing with the parties that the need to protect the disability claimant’s privacy is a compelling reason to file the record under seal (Randolff Scott Ruffell Westover v. Life Insurance Company of North America, No. 20-5606, W.D. Wash., 2020 U.S. Dist. LEXIS 192304).

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