Mealey's Disability Insurance

  • September 05, 2018

    Evidence Supports Finding That Claimant Was Not Disabled From Own Occupation

    NEW YORK — A New York federal judge on Aug. 30 determined that the termination of a disability claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the evidence supports the plan’s finding that the claimant’s hearing loss and tinnitus did not prevent the claimant from performing the duties of her own occupation (Susan Shahgholi v. Aetna Inc. Long Term Disability Benefits Plan, No. 17-963, S.D. N.Y., 2018 U.S. Dist. LEXIS 148400).

  • September 04, 2018

    Claimant Failed To Show Insurer Acted In Bad Faith In Terminating LTD Benefits

    DENVER — A Colorado federal judge on Aug. 29 granted a disability insurer’s motion for summary judgment on a disability plan participant’s claims for common-law bad faith and statutory bad faith after determining that the participant failed to prove that the insurer acted unreasonably in handling a claim for long-term disability benefits (Brenda Sandoval v. Unum Life Insurance Company of America, No. 17-644, D. Col., 2018 U.S. Dist. LEXIS 147184).

  • September 04, 2018

    Minnesota Federal Judge Says Claims Against LTD Insurer Are Not Duplicative

    MINNEAPOLIS — A Minnesota federal judge on Aug. 29 denied a disability insurer’s motion for judgment on the pleadings after determining that a breach of fiduciary claim seeking attorney fees and health care costs as remedies for the breach is not duplicative of the breach of fiduciary claim seeking benefits under a long-term disability (LTD) plan (Michael J. Christoff v. Unum Life Insurance Company of America, No. 17-3512, D. Minn., 2018 U.S. Dist. LEXIS 147188).

  • August 29, 2018

    Termination Of Disability Benefits Supported By Evidence, Federal Judge Says

    DETROIT — A disability insurer properly terminated a claimant’s long-term disability (LTD) benefits because the evidence obtained by the insurer, which includes surveillance video and multiple independent medical reviews, supports the finding that the claimant was not disabled from any occupation, a Michigan federal judge said Aug. 20 (Jill Brown v. Hartford Insurance Co., No. 17-10868, E.D. Mich., 2018 U.S. Dist. LEXIS 140541).

  • August 27, 2018

    Disability Insurer Reasonably Relied On Independent Physicians’ Opinions

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Aug. 23 reversed a district court’s ruling in favor of a disability claimant after determining that the insurer did not abuse its discretion in relying on the opinions of two independent medical reviewers when it denied the claim for benefits (Damon Zaeske v. Liberty Life Assurance Company of Boston, No. 17-2496, 8th Cir., 2018 U.S. App. LEXIS 23768).

  • August 24, 2018

    Split En Banc Veterans Appeals Court Denies Class In Suit Over Benefits Delays

    WASHINGTON, D.C. — A divided en banc Veterans Claims Court of Appeals on Aug. 23 denied a motion for class certification in a lawsuit seeking to expedite certain disability benefits decisions, ruling that individual issues predominate (Conley F. Monk, Jr., et al. v. Robert J. Wilkie, No. 15-1280, Vet. Clms. App., 2018 U.S. App. Vet. Claims LEXIS 1115).

  • August 21, 2018

    4th Circuit Says Disability Income Insurer Did Not Owe Any Benefit Increase

    RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals on Aug. 17 determined that a district court did not abuse its discretion in granting a disability insurer’s motion for reconsideration because the claimant was not entitled to an increase of benefits because the claimed disability was not a new disability as required under the plan at issue (Jessica Slice-Sadler v. Principal Life Insurance Company, No. 17-2249, 4th Cir., 2018 U.S. App. LEXIS 22975).

  • August 14, 2018

    Claimant Entitled To STD Benefits Under Plan, 10th Circuit Panel Affirms

    DENVER — The 10th Circuit U.S. Court of Appeals on Aug. 13 affirmed a district court’s ruling in favor of a disability claimant after determining that the claimant was entitled to short-term disability benefits under his company’s disability plan because the record does not contain substantial evidence showing that the claimant was capable of performing the duties of his job (Kevin McMillan v. AT&T Umbrella Benefit Plan No. 1, No. 17-5111, 10th Cir., 2018 U.S. App. LEXIS 22366).

  • August 09, 2018

    Disability Insurer’s Denial Of Benefits Was Reasonable, Federal Judge Says

    BALTIMORE — A disability insurer did not abuse its discretion in denying a plan participant’s long-term disability benefits claim because the evidence shows that the denial was reasonable and was made after a fair review was conducted, a Maryland federal judge said Aug. 7 (Karin Reidy v. Unum Life Insurance Company of America, No. 16-2926, D. Md., 2018 U.S. Dist. LEXIS 133287).

  • August 09, 2018

    Federal Judge Dismisses Disability Complaint, Says It Is A Shotgun Pleading

    FORT MYERS, Fla. — A Florida federal judge on Aug. 8 dismissed a disability claimant’s complaint with leave to amend after determining that the complaint is a shotgun pleading in violation of Rule 8 of the Federal Rules of Civil Procedure because the complaint includes numerous irrelevant and unnecessary details (Marcus Allen, M.D. v. First Unum Life Insurance Co., et al., No. 18-69, M.D. Fla., 2018 U.S. Dist. LEXIS 133160).

  • August 08, 2018

    Federal Judge Grants Parties’ Joint Motion To Dismiss Disability Benefits Suit

    SACRAMENTO, Calif. — A California federal judge on Aug. 6 dismissed a disability claimant’s suit with prejudice following the parties’ filing of a joint stipulation for dismissal (Brenda Culbertson-Chavira v. Life Insurance Company of North America, No. 17-1702, E.D. Calif., 2018 U.S. Dist. LEXIS 132014).

  • August 07, 2018

    High Court Should Review 9th Circuit’s Offset Ruling, Disability Claimant Says

    WASHINGTON, D.C. — The U.S. Supreme Court should grant review of a disability claimant’s petition for writ of certiorari in a dispute over the offsetting of a claimant’s long-term disability (LTD) benefits to account for Social Security disability income (SSDI) benefits received on behalf of the claimant’s dependents because the plan administrators did not apply the language of the LTD plan as written, the claimant says in a June 22 reply brief (Susan Rene Jones v. Merck Sharpe & Dohme Corp., et al., No. 17-1478, U.S. Sup.).

  • August 06, 2018

    High Court’s Review Of Service-Of-Suit Ruling Is Not Warranted, Respondents Say

    WASHINGTON, D.C. — The U.S. Supreme Court should deny a petition for writ of certiorari because the Colorado Supreme Court’s dismissal of two long-term disability insurance lawsuits based on the failure to serve the proper parties was the proper decision and there is no conflict between federal courts of appeal regarding whether a benefit plan governed by the Employee Retirement Income Security Act is a proper defendant, the respondents argue in a July 25 brief (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.).

  • August 06, 2018

    Disability Claimant Failed To Exhaust All Administrative Remedies, Judge Says

    CONCORD, N.H. — A New Hampshire federal judge on July 23 granted judgment in favor of a disability plan and against a disability claimant after determining that the claimant did not exhaust all administrative remedies before filing suit because she did not timely appeal the insurer’s termination of disability benefits (Theresa Fortier v. Hartford Life and Accident Insurance Co., No. 16-322, D. N.H., 2018 U.S. Dist. LEXIS 126345).

  • August 06, 2018

    Denial Of Disability Benefits Supported By Substantial Evidence, Panel Says

    ATLANTA — A district court did not err in entering judgment in favor of a disability insurer because the insurer’s denial of any-occupation benefits was supported by substantial evidence and the court did not commit “plain error” in finding for the insurer, the 11th Circuit U.S. Court of Appeals said Aug. 3 (Antonio Lopez v. Standard Insurance Co., No. 17-11012, 11th Cir., 2018 U.S. App. LEXIS 21525).

  • August 06, 2018

    5th Circuit Finds Termination Of Disability Benefits Was Reasonable

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Aug. 3 determined that a district court did not err in concluding that substantial evidence supports a disability insurer’s termination of benefits based on the plan’s 24-month limitation for mental disorders (Ricky D. Hayes v. Dearborn National Life Insurance Co., No. 17-30670, 5th Cir., 2018 U.S. App. LEXIS 21608).

  • August 01, 2018

    Disability Claimant Received Full And Fair Review, 4th Circuit Panel Says

    RICHMOND, Va. — A disability insurer did not abuse its discretion in terminating a claimant’s disability benefits because the record shows that the claimant received a full and fair review of his claim, the Fourth Circuit U.S. Court of Appeals said July 31 (Scott Griffin v. Hartford Life & Accident Insurance Co., No. 17-1251, 4th Cir., 2018 U.S. App. LEXIS 21166).

  • July 31, 2018

    Claimant Entitled To LTD Benefits For West Nile Virus, Judge Says

    DENVER — A disability claimant is entitled to past and future long-term disability benefits because the insurer’s termination of benefits was an abuse of discretion because the weight of the evidence supported a finding that the claimant was disabled as a result of West Nile virus, a Colorado federal judge said July 26 (Michael J. Paquin v. Prudential Insurance Company of America, No. 16-02142, D. Colo., 2018 U.S. Dist. LEXIS 125231).

  • July 26, 2018

    Federal Magistrate Judge Says Compensation Paid To Reviewing Doctor Is Relevant

    NEW ORLEANS — A Louisiana federal magistrate judge on July 11 partially denied a disability insurer’s motion to quash a subpoena seeking compensation records from a physician hired by the insurer to review a disability claimant’s file after determining that the discovery sought is relevant and permitted under the Employee Retirement Income Security Act (Anne Wittmann v. Unum Life Insurance Company of America, No. 17-9501, E.D. La., 2018 U.S. Dist. LEXIS 115848).

  • July 26, 2018

    Disability Claimant Not Entitled To Attorney Fees, Michigan Federal Judge Says

    CINCINNATI — A disability claimant is not entitled to an award for attorney fees and costs because the plan administrator’s conduct in failing to schedule an in-person medical exam does not suggest a high level of culpability, a Michigan federal judge said July 17 (Kimberly J. Guest-Marcotte v. Life Insurance Company of North America, et al., No. 15-10738, E.D. Mich., 2018 U.S. App. LEXIS 8105).

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