Mealey's Disability Insurance

  • November 07, 2018

    Termination Of Disability Benefits Did Not Amount To Bad Faith, Judge Says

    WILLIAMSPORT, Pa. — A Pennsylvania federal judge on Nov. 2 granted a motion for summary judgment filed by the insurers in a disability dispute after determining that the claimant failed to prove that the termination of his benefits was unreasonable and made in bad faith (Dr. Robert Brugler v. Unum Group, et al., No. 15-1031, M.D. Pa., 2018 U.S. Dist. LEXIS 187836).

  • November 05, 2018

    Issue Of Fact Exists As To Whether Disability Insurer’s Determination Was Reasonable

    PHOENIX — A disability claimant’s bad faith claim and request for punitive damages can proceed because the claimant presented an issue of fact as to whether the insurer’s termination of disability benefits was reasonable, an Arizona federal judge said Nov. 1 in denying the insurer’s motion for summary judgement (Kelly Ann Tyler v. United States Life Insurance Co., et al., No. 16-939, D. Ariz., 2018 U.S. Dist. LEXIS 187001).

  • November 02, 2018

    Judge Grants Motion To Exclude Documents Filed After Claimant Initiated Suit

    NEW ORLEANS — A Louisiana federal judge on Oct. 31 granted a disability claimant’s motion to exclude documents generated after a lawsuit was filed against the disability insurer because the administrative record closed after the claimant filed suit (Anne Wittmann v. Unum Life Insurance Company of America, No. 17-9501, E.D. La., 2018 U.S. Dist. LEXIS 186064).

  • November 02, 2018

    Disability Suit Must Be Transferred From New Jersey To Tennessee Federal Court

    NEWARK, N.J. — A disability claimant’s suit alleging wrongful denial of long-term disability (LTD) benefits must be transferred from New Jersey federal court to Tennessee federal court because the alleged breach of the terms of the plan occurred in Tennessee and the parties’ interests weigh in favor of transfer to Tennessee federal court, a New Jersey federal magistrate judge said Oct. 31 (Wesley Gonce v. Prudential Insurance Company of America, No. 18-8662, D. N.J., 2018 U.S. Dist. LEXIS 186905).

  • October 31, 2018

    Disability Insurer Did Not Breach Policy Terms, Judge Says In Dismissing Complaint

    UTICA, N.Y. — A disability claimant’s breach of contract suit must be dismissed because the disability insurer did not breach the terms of the long-term disability (LTD) policy when it terminated the claimant’s benefits at age 65, a New York federal judge said Oct. 30, noting that the insurer paid the maximum period of payment per the terms of the policy (Vincent J. Krocka v. Mutual of New York Insurance Co., No. 18-830, N.D. N.Y., 2018 U.S. Dist. LEXIS 185173).

  • October 30, 2018

    Supplemental Plan Is Governed By ERISA, 3rd Circuit Determines

    PHILADELPHIA — A supplemental disability plan offered by a disability claimant’s former employer is governed under the Employee Retirement Income Security Act because the claimant failed to prove that a reasonable employee would view the supplemental plan as a third-party offering not affiliated with the employer, the Third Circuit U.S. Court of Appeals said Oct. 5 (Kevin M. McCann, M.D. v. Unum Provident, et al., No. 16-2014, 3rd Cir., 2018 U.S. App. LEXIS 29638).

  • October 25, 2018

    Judge Strikes Claimant’s Exhibit, Says Letter Is Not Part Of Administrative Record

    CAPE GIRARDEAU, Mo. — A Missouri federal judge on Oct. 24 granted a disability insurer’s motion to strike a letter offered as an exhibit to a claimant’s complaint after determining that the letter, which states that the claimant’s disability was not caused by a pre-existing condition, is not part of the administrative record because the claimant failed to provide the letter to the insurer during the administrative appeal process (Stacey Waite v. Sun Life Assurance Co., No. 18-208, E.D. Mo., 2018 U.S. Dist. LEXIS 182354).

  • October 25, 2018

    Federal Judge Remands LTD Claim To Administrator For New Determination

    LITTLE ROCK, Ark. — A disability insurer must reconsider a long-term disability (LTD) claim after reviewing the claimant’s Social Security disability benefits records because the insurer represented to the claimant that the Social Security records would be considered as part of the review of the claimant’s appeal, an Arkansas federal judge said Oct. 18 in remanding the claim to the administrator (Michael Buquoi v. United States Life Insurance Co., No. 18-093, E.D. Ark., 2018 U.S. Dist. LEXIS 179172).

  • October 19, 2018

    Federal Judge Grants Disability Insurer’s Motion For Judgment On Pleadings

    BOSTON — A Massachusetts federal judge on Oct. 16 granted a disability insurer’s motion for judgment on the pleadings in a U.S. Army veteran’s class action alleging that the insurer wrongfully offset disability benefits payable under its policy by disability benefits received from the U.S. Department of Veterans Affairs after determining that the remaining claims cannot stand based on the court’s prior ruling that the offset was permitted under the plan (Marco Martinez v. Sun Life Assurance Company of Canada, No. 16-12154, D. Mass., 2018 U.S. Dist. LEXIS 178188).

  • October 17, 2018

    Disability Claimant Failed To Prove That Exhaustion Of Remedies Would Be Futile

    SIOUX CITY, Iowa — An Iowa federal judge on Oct. 16 granted a disability insurer’s motion to dismiss a claim alleging wrongful denial of long-term disability (LTD) benefits because the claimant failed to exhaust all administrative remedies under the LTD policy and failed to prove that exhaustion would be futile (Brandy J. Sievers v. United of Omaha Life Insurance Co., No. 18-3048, N.D. Iowa, 2018 U.S. Dist. LEXIS 177259).

  • October 12, 2018

    Magistrate: Termination Of LTD Benefits Was Reasonable Based On Evidence

    SALT LAKE CITY —A Utah federal magistrate judge on Oct. 9 denied a disability claimant’s motion for summary judgment after determining that the disability insurer’s termination of long-term disability (LTD) benefits was reasonable and is supported by substantial evidence (Jon E. Sadler v. United of Omaha Life Insurance Co., No. 17-979, D. Utah, 2018 U.S. Dist. LEXIS 174428).

  • October 11, 2018

    Disability Claimant’s Benefits Were Not Wrongfully Terminated, Judge Says

    MINNEAPOLIS — A claimant’s long-term disability (LTD) benefits were not wrongfully terminated because the record shows that the evidence supports the plan’s determination that the claimant was not disabled from working in any occupation, a Minnesota federal judge said Oct. 9 (Doris Rogers v. Eaton Corp., et al., No. 17-4391, D. Minn., 2018 U.S. Dist. LEXIS 173580).

  • October 09, 2018

    Disability Claimant Awarded $20,000 In Attorney Fees Incurred As A Result Of Appeal

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Oct. 4 awarded a disability claimant $20,000 in attorney fees incurred in his appeal over a dispute regarding the claimant’s entitlement to own-occupation long-term disability (LTD) benefits (Dave Nagy v. Group Long Term Disability Plan for Employees of Oracle America Inc., et al., Nos. 16-16160, 9th Cir., 2018 U.S. App. LEXIS 28166).

  • October 05, 2018

    New York Federal Judge Adjusts Disability Claimant’s Attorney Fee Award

    CENTRAL ISLIP, N.Y. — A New York federal judge on Sept. 28 rejected a disability plaintiff’s challenge to the hourly rate used by a magistrate judge to calculate attorney fees and adjusted an overall reduction in the amount of billed hours, resulting in an award of more than $222,000 in attorney fees in favor of the claimant (Janet Solnin v. Sun Life and Health Insurance Co., et. al., No. 08-2759, E.D. N.Y., 2018 U.S. Dist. LEXIS 168047).

  • October 05, 2018

    Benefits Properly Denied Based On Disability Claimant’s Pre-Existing Condition

    DENVER — A disability insurer properly denied long-term disability (LTD) benefits based on the plan’s pre-existing condition provision because the claimant was diagnosed with a condition that caused his loss of sight three months before filing a claim for disability benefits, the 10th Circuit U.S. Court of Appeals said Sept. 26 (Michael Green v. Life Insurance Company of North America, No. 17-1383, 10th Cir., 2018 U.S. App. LEXIS 27439).

  • October 04, 2018

    Termination Of LTD Benefits Was Reasonable Based On Surveillance Video, Panel Says

    ATLANTA — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s termination was reasonable based on surveillance video of the claimant and based on independent physician reviews it obtained, the 11th Circuit U.S. Court of Appeals said Oct. 1 (Timothy P. O’Leary v. Aetna Life Insurance Co., No. 17-15162, 11th Cir., 2018 U.S. App. LEXIS 27771).

  • October 03, 2018

    Panel Reverses Dismissal Of Fiduciary Breach Claim Against Disability Plan

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Oct. 1 reversed and remanded a district court’s dismissal of a disability plan participant’s claims for breach of fiduciary duty and for failure to provide plan documents against the disability plan after determining that the district court failed to consider the plan participant’s argument that the plan documents provided by the employer are somewhat different from the copies, provided by the plan insurer, in the administrative record (Michael N. Manuel v. Turner Industries Group LLC et al., No. 17-30835, 5th Cir., 2018 U.S. App. LEXIS 27810).

  • October 01, 2018

    Judge: ERISA Does Not Apply To Foreign Nationals Working Outside Of United States

    PHILADELPHIA — After finding support for a disability claimant’s argument that the Employee Retirement Income Security does not apply to foreign nationals working outside of the United States, a Pennsylvania federal judge on Sept. 27 rejected the insurer’s argument that the claims are preempted under ERISA and remanded the disability claimant’s suit to state court (Salih Bajrami v. Reliance Standard Life Insurance Co., No. 18-162, E.D. Pa., 2018 U.S. Dist. LEXIS 166098).

  • October 01, 2018

    Supreme Court Denies Review Of Service-Of-Suit Ruling In Disability Dispute

    WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 1 denied a petition for writ of certiorari seeking review of the Colorado Supreme Court’s dismissal of two long-term disability insurance lawsuits based on its finding that the benefit plan governed by the Employee Retirement Income Security Act is not a proper defendant (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.).

  • October 01, 2018

    High Court Denies Review Of 9th Circuit’s Disability Offset Ruling

    WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 1 denied a disability claimant’s petition for writ of certiorari in a dispute regarding the offsetting of the claimant’s long-term disability (LTD) benefits to account for Social Security disability income (SSDI) benefits received on behalf of the claimant’s dependents (Susan Rene Jones v. Merck Sharpe & Dohme Corp., et al., No. 17-1478, U.S. Sup.).

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