Mealey's Disability Insurance

  • September 27, 2018

    Disability Suit Will Remain In California; Transfer To Georgia Not Warranted

    SAN FRANCISCO — A California federal judge on Sept. 24 denied a disability plan’s motion to transfer a disability claimant’s suit to Georgia, where the claimant lived and was treated for his disability, after determining that the claimant’s choice of forum is entitled to some deference and that none of the convenience factors weighs strongly in favor of transferring the suit (Mark Ennis v. Aetna Life Insurance Co. et al., No. 18-1617, N.D. Calif., 2018 U.S. Dist. LEXIS 163442).

  • September 27, 2018

    Insurer Failed To Consider If Claimant Could Perform Job With ‘Reasonable Continuity’

    OAKLAND, Calif. — A disability insurer wrongfully denied long-term disability (LTD) benefits to a plan participant suffering from liver cancer because the insurer failed to consider whether the participant could continue to perform the duties of his job with “reasonable continuity,” a California federal judge said Sept. 19 (Shelley Lyttle v. United of Omaha Life Insurance Co., No. 17-1361, N.D. Calif., 2018 U.S. Dist. LEXIS 160300).

  • September 26, 2018

    Disability Claimant Failed To Exhaust Administrative Remedies, Judge Says

    CHATTANOOGA, Tenn. — A Tennessee federal judge on Sept. 25 granted a disability insurer’s motion for summary judgment and denied a disability claimant’s motion for summary judgment because the claimant failed to exhaust all administrative remedies before filing suit and failed to prove that exhausting all administrative remedies would have been futile (Lisa House v. Unum Life Insurance Company of America et al., No. 17-220, E.D. Tenn., 2018 U.S. Dist. LEXIS 164124).

  • September 26, 2018

    Termination Of Disability Benefits Was Not An Abuse Of Discretion, Judge Says

    CAMDEN, N.J. — A disability insurer did not abuse its discretion in terminating a claimant’s long-term disability benefits because the insurer consulted with numerous medical experts and conducted a thorough investigation before terminating benefits, a New Jersey federal judge said Sept. 21 (Daniel Naphys v. Prudential Insurance Company of America, No. 16-1450, D. N.J., 2018 U.S. Dist. LEXIS 162302).

  • September 24, 2018

    Disability Claimant’s LTD Benefits Reinstated; Evidence Supports Disability

    BOSTON — A disability claimant is entitled to the reinstatement of long-term disability (LTD) benefits and past due benefits because the claimant met her burden of proving that she is disabled as a result of fibromyalgia from working in her own occupation, a Massachusetts federal judge said Sept. 21 (Judith Kamerer v. Unum Life Insurance Company of America, No. 15-40146, D. Mass., 2018 U.S. Dist. LEXIS 161522).

  • September 20, 2018

    Arbitrary, Capricious Standard Of Review Applies, Federal Judge Determines

    PIKEVILLE, Ky. — An arbitrary and capricious standard of review applies in disability suit because the disability plan delegates discretionary authority to the insurer for the administration of claims made under the plan, a Kentucky federal judge said Sept. 18 (Regina Hurd v. Life Insurance Company of North America, No. 18-67, E.D. Ky., 2018 U.S. Dist. LEXIS 158595).

  • September 20, 2018

    Federal Judge Says Disability Insurer Must Determine If Claimant Was ‘Made Whole’

    COLUMBUS, Ohio — An Ohio federal judge on Sept. 18 remanded a claim to a disability insurer for further fact finding on the issues of whether a disability claimant was made whole by a settlement she received following injuries sustained in a car accident and whether the disability claimant’s benefits can be offset based on the settlement (Sepanta Jalali v. Unum Life Insurance Company of America, No. 16-512, S.D. Ohio, 2018 U.S. Dist. LEXIS 159015).

  • September 18, 2018

    Disability Claimant Failed To Challenge District Court’s Ruling, Panel Says

    CINCINNATI — The Sixth Circuit U.S. Court of Appeal on Sept. 11 affirmed a district court’s ruling in favor of a retirement benefits plan because the appellant, seeking retirement disability benefits, failed to challenge the district court’s finding that the retirement plan was properly amended to delete a provision stating that a claimant would be considered totally disabled if the Social Security Administration (SSA) declared the claimant disabled (Patsy Saylor v. Appalachian Regional Hospital, No. 17-6266, 6th Cir., 2018 U.S. App. LEXIS 25828).

  • September 18, 2018

    Supplemental Disability Policy Not Part Of Employee Welfare Benefit Plan, Judge Says

    MINNEAPOLIS — A breach of contract claim is not preempted by the Employee Retirement Income Security Act because the supplemental disability policy at issue is not part of an employee welfare benefit plan under ERISA, a Minnesota federal judge said Sept. 14 in adopting a magistrate judge’s recommendation to deny the insurer’s motion for summary judgment (Matthew J. Christoff v. Paul Revere Life Insurance Co., No. 17-3515, D. Minn., 2018 U.S. Dist. LEXIS 157107).

  • September 18, 2018

    Evidence Supports Finding That Claimant Was Not Disabled From Any Occupation

    NEW YORK — A disability insurer’s denial of a claimant’s long-term disability benefits claim was not arbitrary and capricious because substantial medical evidence supports the insurer’s determination that the claimant was not disabled from any occupation, a New York federal judge said Sept. 14 (Lazer Wagschal v. Principal Life Insurance Co., No. 16-1029, S.D. N.Y., 2018 U.S. Dist. LEXIS 157319).

  • September 17, 2018

    Termination Of Disability Benefits Was Arbitrary And Capricious, Majority Says

    CHICAGO — A disability insurer acted arbitrarily and capriciously when it failed to consider the opinions of four doctors in favor of one doctor who determined that a disability claimant was not disabled as a result of radiculopathy, a majority of the Seventh Circuit U.S. Court of Appeals said Sept. 14 reversing a district court’s opinion and remanding the claim to the plan administrator (Susan Hennen v. Metropolitan Life Insurance Co., No. 17-3080, 7th Cir., 2018 U.S. App. LEXIS 26114).

  • September 13, 2018

    Disability Insurer’s Summary Judgment Motion Should Be Granted, Magistrate Judge Says

    WASHINGTON, D.C. — A District of Columbia federal magistrate judge on Sept. 11 recommended that a disability’s claimant’s motion for summary judgment be denied and the disability insurer’s motion for summary judgment be granted after determining that the evidence supports the insurer’s denial of benefits (Elaine Arabaitzis v. Unum Life Insurance Company of America, No. 16-1273, D. D.C.).

  • September 13, 2018

    Denial Of Disability Benefits Was Not Arbitrary, Capricious, Federal Judge Says

    LEXINGTON, Ky. — A disability insurer’s denial of long-term disability benefits was not arbitrary and capricious because substantial evidence in the record supports the insurer’s denial, a Kentucky federal judge said Sept. 11 in granting the insurer’s motion for summary judgment (Susan Card v. Principal Life Insurance Co., No. 15-139, E.D. Ky., 2018 U.S. Dist. LEXIS 154563).

  • September 12, 2018

    Bad Faith Claim Against Disability Income Insurer Is Premature, Judge Says

    TAMPA, Fla. — A Florida federal judge on Sept. 11 dismissed an insured’s bad faith claim without prejudice after determining that the claim arising out of a disability income insurer’s termination of benefits is premature (Susan Welsh v. General American Life Insurance Co., No. 18-1227, M.D. Fla., 2018 U.S. Dist. LEXIS 154487).

  • September 11, 2018

    2nd Circuit Affirms Denial Of Benefits Based On Plan’s Mental Illness Provision

    NEW YORK — The Second Circuit U.S. Court of Appeals on Sept. 7 affirmed a district court’s ruling that a disability insurer did not act arbitrarily and capriciously in relying on the American Psychiatric Association's definition of mental illness when determining that bipolar disorder is a mental illness and subject to the plan's 24-month cap on disability benefits for a mental illness (Marry Kim v. The Hartford Life Insurance Co., No. 17-2122, 2nd Cir., 2018 U.S. App. LEXIS 25389).

  • September 07, 2018

    Claimant Was Not Disabled From Any Occupation, Federal Judge Determines

    ALLENTOWN, Pa. — A disability insurer’s termination of long-term disability benefits was not arbitrary and capricious because substantial evidence supports the insurer’s determination that the claimant was not disabled from performing the duties of any gainful occupation, a Pennsylvania federal judge said Aug. 13 (Giovanna Reichard v. United of Omaha Life Insurance Co., No. 17-2885, E.D. Pa., 2018 U.S. Dist. LEXIS 136050).

  • September 07, 2018

    Disability Plan Is Ambiguous As To Exhaustion Requirement, Federal Judge Says

    BRIDGEPORT, Conn. — A Connecticut federal judge on Aug. 28 denied a disability insurer’s motion to dismiss after determining that the disability plan does not include an express exhaustion provision and that it is possible for a plan participant to interpret the plan as not requiring exhaustion prior to filing suit (Annuziata Germana, et al. v. Reliance Standard Life Insurance Co., No. 16-1611, D. Conn., 2018 U.S. Dist. LEXIS 146074).

  • September 07, 2018

    Claimant Is Entitled To Reinstatement Of LTD Benefits, Federal Judge Says

    TULSA, Okla. — An Oklahoma federal judge on Aug. 17 determined that a claimant’s long-term disability (LTD) benefits must be reinstated because the denial of benefits is not supported by substantial evidence and was arbitrary and capricious (Shirley Kathy Redden v. Aetna Life Insurance Co., No. 12-16, N.D. Okla., 2018 U.S. Dist. LEXIS 139733).

  • September 06, 2018

    Disability Insurer Properly Terminated Benefits, Federal Judge Determines

    PHILADELPHIA — A Pennsylvania federal judge on Aug. 23 determined that a disability insurer’s termination of long-term disability (LTD) benefits was proper because the claimant failed to prove that she was disabled under the plan’s any-occupation standard and because the claimant collected the maximum amount of available benefits available under the plan’s mental health limitation (Kristy M. Keller-Smith v. Reliance Standard Life Insurance Co., No. 17-1549, E.D. Pa., 2018 U.S. Dist. LEXIS 144425).

  • September 06, 2018

    Information Challenging Administrative Record In Disability Suit Is Discoverable

    NEW ORLEANS — A Louisiana federal magistrate judge on Aug. 16 determined that a disability claimant is entitled to some discovery as some of the claimant’s requests challenge the completeness of the administrative record and some of the requests seek discoverable information regarding the insurer’s retention of third-party medical professionals (Jeanne Sirey v. Metropolitan Life Insurance Co., No. 18-197, E.D. La., 2018 U.S. Dist. LEXIS 138732).

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