PHILADELPHIA — The U.S. Supreme Court should review the Third Circuit U.S. Court of Appeals’ finding that a district court properly remanded a claim for long-term disability (LTD) benefits to determine whether benefits are available under a plan’s any-occupation standard because a conflict exists among the circuit courts as to whether it would be futile for the disability claimant on remand to seek benefits under a plan’s any-occupation standard if benefits were previously denied under a plan’s own-occupation standard, the disability claimant maintains in a July 26 petition for writ of certiorari (Thomas P. Kelly Jr. v. Reliance Standard Life Insurance Co., et al., No. 18-1162, 3rd Cir.).
SAN JOSE, Calif. — A bad faith claim alleged against a disability insurer can proceed because questions of fact exist as to whether the insurer’s termination of long-term disability benefits was unreasonable and as to whether the bad faith claim is subject to the applicable two-year statute of limitations, a California federal judge said Aug. 2 in denying the insurer’s motion for summary judgment (Stephanie Jensen v. Dearborn National Life Insurance Co., No. 17-7320, N.D. Calif., 2019 U.S. Dist. LEXIS 129835).
SCRANTON, Pa. — A Pennsylvania federal judge on July 29 partially denied a disability insurer’s motion for a protective order regarding information sought in depositions after determining that the fiduciary exception to the attorney-client privilege does not apply to communications regarding the administration of the disability plan concerning subrogation shared among the plan, its fiduciaries and any attorney assisting in the administration of the plan prior to the filing of the disability claimant’s lawsuit (Eric Yost, et al. v. Anthem Life Insurance Co., No. 3:16-cv-00079, M.D. Pa., 2019 U.S. Dist. LEXIS 125967).
PHILADELPHIA — A pension plan’s board of trustees did not act arbitrarily or capriciously when it determined that a plan participant’s vacation pay does not count as benefit hours, the Third Circuit U.S. Court of Appeals said July 24 in affirming a district court’s ruling that the plan participant is not entitled to disability benefits under the pension plan because the participant did not meet the required hours of service necessary to collect disability benefits (Norman Hansen v. International Union of Painters & Allied Trades Industry Pension Plan, et al., No. 18-2921, 3rd Cir., 2019 U.S. App. LEXIS 22066).
CINCINNATI — A Sixth Circuit U.S. Court of Appeals panel majority on July 18 affirmed a district court’s denial of a disability claimant’s motion to remand, agreeing with the lower court that the insurer proved by a preponderance of the evidence that the amount in controversy exceeds $75,000 (James Heyman v. Lincoln National Life Insurance Co., No. 18-5622, 6th Cir., 2019 U.S. App. LEXIS 21254).
LAKE CHARLES, La. — A disability plan committee’s interpretation of plan documents was an abuse of discretion because the disability plan was ambiguous as to whether a written application for disability retirement benefits was required, a Louisiana federal judge said July 22 in granting a disability claimant’s motion for summary judgment (John R. Ketchum v. Saint-Gobain Corp., No. 18-562, W.D. La., 2019 U.S. Dist. LEXIS 123743).
BAY CITY, Mich. — A Michigan federal judge on July 26 awarded a disability claimant attorney fees and costs but refused to award the claimant prejudgment interest because the claimant did not obtain a monetary award against the disability insurer (Kimberly Guest-Marcotte v. Life Insurance Company of North America, No. 15-10738, E.D. Mich., 2019 U.S. Dist. LEXIS 125061).
SALT LAKE CITY — A Utah federal judge on July 25 denied a disability insurer’s motion to alter or amend an opinion finding that a disability claimant is eligible for disability benefits after determining that the decision was not clear error and was not contrary to precedent established by the 10th Circuit U.S. Court of Appeals (David G. Carlile v. Reliance Standard Insurance Co., No. 17-1049, D. Utah, 2019 U.S. Dist. LEXIS 125026).
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on July 25 affirmed a district court’s dismissal of a disability claimant’s suit because the claimant clearly failed to file suit within three years of the accrual of his claim as required by the plan (Michael Faciane v. Sun Life Assurance Company of Canada, No. 18-30918, 5th Cir., 2019 U.S. App. LEXIS 222320).
SACRAMENTO, Calif. — A California federal judge on July 18 dismissed a disability claimant’s suit after determining that a rider that ended the application of mental disorder limitations did not apply to the claimant’s disability income policy because the rider attached only to disability income policies with a duration of two years or less (Joy Wiseblood v. Mutual of Omaha Insurance Co., et al., No. 18-3082, E.D. Calif., 2019 U.S. Dist. LEXIS 120210).
MONTGOMERY, Ala. — A disability insurer did not act arbitrarily and capriciously in denying total disability benefits to a claimant because the insurer’s decision was reasonable based on the medical evidence, an Alabama federal judge said July 12 (Anthony Bowman v. Reliance Standard Life Insurance Co., No. 11-1046, M.D. Ala., 2019 U.S. Dist. LEXIS 116110).
MONTGOMERY, Ala. — An Alabama federal judge on July 17 dismissed a civil conspiracy claim against a disability life insurer in an insured’s breach of contract and bad faith case against the insurer and a reinsurer over the denial of disability benefits (Horace R. Theriot Jr. v. The Northwestern Mutual Life Insurance Co., et al., No. 18-688, M.D. Ala.).
BOSTON — A Massachusetts federal judge on July 11 granted summary judgment in favor of a disability plan after determining that the plan’s termination of partial disability benefits was not arbitrary and capricious because the claimant exhausted the plan’s lifetime maximum for partial disability benefits and the medical evidence supported the plan’s finding that the claimant was not totally disabled (Donald Hammond v. Procter & Gamble Health and Long Term Disability Plan, No. 18-11343, D. Mass., 2019 U.S. Dist. LEXIS 115105).
BOSTON — A Massachusetts federal judge on July 11 granted a disability claimant’s motion to dismiss a disability insurer’s counterclaim seeking to recover an alleged overpayment of benefits after determining that discovery on the issue of the overpayment is necessary (Karen Jette v. United of Omaha Life Insurance Co., No. 18-11650, D. Mass., 2019 U.S. Dist. LEXIS 115973).
BRIDGEPORT, Conn. — A Connecticut federal judge on July 9 determined that a trial must be scheduled in a disability benefits suit because a question of fact exists as to whether the claimant can become qualified for the occupations identified by the disability insurer (Jeff Schuman v. Aetna Life Insurance Co., et al, No. 15-1006, D. Conn., 2019 U.S. Dist. LEXIS 113375).
ST. LOUIS — A district court did not err in granting a disability insurer’s motion for summary judgment because the insurer’s denial of benefits is supported by the medical evidence in the administrative record, the Eighth Circuit U.S. Court of Appeals said July 3 (David C. Nicholson v. Standard Insurance Co., et al., No. 18-1848, 8th Cir., 2019 U.S. App. LEXIS 19909).
CAPE GIRARDEAU, Mo. — A Missouri federal judge on June 20 granted summary judgment in favor of a disability plan after determining that substantial evidence supports the plan’s denial of total disability benefits to a claimant who exhausted the maximum amount of partial disability benefits available under the plan (Charlie Craig Hounihan v. The Proctor & Gamble Disability Committee, et al., No. 18-010, E.D. Mo., 2019 U.S. Dist. LEXIS 103248).
CHARLESTON, W.Va.— The termination of a claimant’s disability benefits was not unreasonable because an insurer properly concluded that the claimant was no longer disabled from his own occupation as an attorney based on his decision to accept a full-time position as an attorney after resigning from his former law firm, a West Virginia federal judge said June 26 (Vaughn T. Sizemore v. Northwestern Mutual Life Insurance Co., No. 17-789, S.D. W.Va., 2019 U.S. Dist. LEXIS 106972).
PHILADELPHIA — A Pennsylvania federal judge on June 24 remanded 12 separate lawsuits filed by foreign nationals alleging claims for breach of contract and bad faith against a disability insurer after determining that federal jurisdiction does not exist because Congress has not clearly expressed that the Employee Retirement Income Security Act applies extraterritorially (In re Reliance Standard Life Insurance Co. et. al., Nos. 19-331; 19-332; 19-333; 19-334; 19-335; 19-336; 19-338; 19-339; 19-340; 19-341; 19-342; 19-343, E.D. Pa., 2019 U.S. Dist. LEXIS 104922).
RICHMOND, Va. — A disability insurer abused its discretion in terminating a claimant’s long-term disability (LTD) benefits because a wealth of medical evidence supports a finding that the claimant was not capable of working in a sedentary position and was totally disabled under the terms of the disability plan, the Fourth Circuit U.S. Court of Appeals said June 20 (Fredrick E. Smith, et al. v. Reliance Standard Life Insurance Co., No. 18-2225, 4th Cir., 2019 U.S. App. LEXIS 18518).