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Mealey's Disability Insurance

  • April 18, 2024

    Judge Says Claims Against Disability Plan, Claims Administrator Can Proceed

    KANSAS CITY, Mo. — A Missouri federal judge denied a motion to dismiss filed by disability plan defendants after determining that the claim for wrongful denial of benefits against the claims administrator can proceed because the plan delegated fiduciary discretion to the claims administrator and the claim for breach of fiduciary duty alleged against the plan and the claims administrator can proceed because the claim is not duplicative of the wrongful denial of benefits claim.

  • April 17, 2024

    LTD Claim Excluded By Policy’s Preexisting Condition Exclusion, 9th Circuit Says

    PASADENA, Calif. — A district court did not err in entering judgment in favor of a disability insurer because the long-term disability (LTD) policy’s preexisting condition exclusion barred coverage as the disability claimant received medical treatment for symptoms related to the claimed disability within three months prior to the effective date of coverage of the policy, the Ninth Circuit U.S. Court of Appeals said.

  • April 12, 2024

    Failure To Offer Proof Of Continued Disability Supports Termination, Plan Says

    PHILADELPHIA — A disability claimant’s failure to provide proof of a continued disability when her long-term disability (LTD) benefits were terminated supports the reasonableness of the disability plan’s termination of benefits and warrants the reversal of a district court’s judgment in favor of the claimant, the disability plan maintains in its appellant reply brief filed in the Third Circuit U.S. Court of Appeals.

  • April 10, 2024

    District Court Must Hold Bench Trial Based On Fact Issues In Disability Suit

    RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals on April 9 vacated and remanded a district court’s summary judgment ruling in favor of a disability insurer after determining that the lower court was required to hold a bench trial based on a Fourth Circuit ruling, issued after the district court’s decision, that clarifies the need for a bench trial in cases where issues of material fact are in dispute.

  • April 10, 2024

    Panel Rejects Disability Claimant’s Attempt To Recover Mental Anguish Damages

    ATLANTA — A district court did not err in finding that a disability claimant could not seek mental anguish damages on a breach of contract claim because mental anguish damages for breach of contract claims are barred under Alabama law, the 11th Circuit U.S. Court of Appeals said in affirming.

  • April 04, 2024

    Termination Of LTD Benefits Was Not Abuse Of Discretion, Judge Says

    ST. LOUIS — A disability plan’s termination of a claimant’s long-term disability benefits was not an abuse of discretion because the decision was reasonable based on the objective medical evidence, a Missouri federal judge said in partially granting the plan’s motion for summary judgment.

  • April 04, 2024

    Disability Insurer Must Reinstate Claimant’s LTD Benefits, Judge Says

    MINNEAPOLIS — A Minnesota federal judge ordered a disability insurer to reinstate a claimant’s long-term disability (LTD) benefits after determining that the insurer failed to show that a lack of objective medical evidence supported its termination of benefits.

  • April 03, 2024

    Panel: Court Properly Found Termination Of Benefits Was Not Arbitrary, Capricious

    NEW YORK — A district court properly entered judgment in favor of a disability insurer because the insurer’s termination of a claimant’s benefits under the disability plan’s any occupation standard was not arbitrary and capricious, the Second Circuit U.S. Court of Appeals said April 2.

  • April 03, 2024

    Disability Claimant Owed LTD Benefits Under Own-Occupation Standard, Judge Says

    NEW YORK — A disability claimant is entitled to long-term disability (LTD) benefits for the first 24 months of his disability because the evidence supports a finding that the claimant is disabled from the duties of his own occupation, a New York federal judge said in granting the claimant’s motion for judgment on the administrative record.

  • April 02, 2024

    Disability Claimant’s Suit Reopened To Determine If Plan Complied With Remand Order

    TULSA, Okla. — An Oklahoma federal judge reopened a disability claimant’s suit to consider whether the disability plan administrator failed to follow the court’s remand order regarding clarification of the plan’s denial of the claimant’s short-term disability (STD) claim.

  • April 02, 2024

    Denial Of STD Benefits Claim Was Not Arbitrary, Capricious, Judge Says

    SALT LAKE CITY — A disability insurer’s denial of short-term disability (STD) benefits was not arbitrary and capricious because the disability claimant failed to submit sufficient evidence showing that he was entitled to benefits, a Utah federal judge concluded in granting the insurer’s motion for summary judgment.

  • March 29, 2024

    Panel Enters Judgment For Disability Claimant; Opinion Temporarily Filed Under Seal

    PITTSBURGH — A panel of the Third Circuit U.S. Court of Appeals issued judgment in favor of a disability claimant, vacating and remanding a district court’s ruling in favor of the disability plan; however, the panel filed the opinion under seal to allow the parties to submit proposed redactions.

  • March 28, 2024

    Trial Court Properly Awarded Sanctions To Disability Insurer, California Panel Says

    SANTA ANA, Calif. — A trial court properly sustained a disability insurer’s demurrer of an insured’s breach of contract and bad faith suit and properly awarded sanctions to the disability insurer because the suit was the third suit filed against the insurer and the insured failed to meet his burden of showing that the third suit was not frivolous or without merit, the Fourth District California Court of Appeals said.

  • March 25, 2024

    Disability Claimant Met Burden Of Proving He Remained Disabled Under Terms Of Plan

    KNOXVILLE, Tenn. — A disability claimant met his burden of proving by a preponderance of the evidence that he remained disabled as a result of multiple sclerosis and that his long-term disability (LTD) benefits were improperly terminated, a Tennessee federal judge said in granting he claimant’s motion for judgment on the administrative record.

  • March 25, 2024

    Medical Doctor Is Entitled To Additional LTD Benefits For Post-Viral Complications

    MINNEAPOLIS — A medical doctor who suffered post-viral complications from a suspected case of COVID-19 is entitled to additional long-term disability (LTD) benefits because she met her burden of showing that she was partially disabled for the entirety of 2021.

  • March 22, 2024

    Federal Judge Awards Disability Claimant More Than $187K In Attorney Fees

    NEW YORK — A New York federal judge awarded a disability claimant more than $187,000 in attorney fees after finding that the award is warranted based on the claimant’s success on the merits of his claims for disability benefits and waiver of life insurance premium benefits and after applying a 10% reduction to the billed attorney fee rates and a 5% reduction to the billed number of hours.

  • March 20, 2024

    Termination Of Benefits Was Not Arbitrary, Capricious, New York Federal Judge Says

    WHITE PLAINS, N.Y. — Substantial evidence supports a disability insurer’s finding that a disability claimant is not disabled from performing the duties of any occupation, a New York federal judge said, noting that an independent medical exam report and multiple independent peer review reports support the disability insurer’s determination.

  • March 19, 2024

    Disability Insurer’s Denial Of Benefits Was Not De Novo Wrong, Judge Says

    TAMPA, Fla. — A disability insurer’s denial of disability benefits was not de novo wrong because the disability claimant failed to show that he was disabled prior to his retirement, a Florida federal judge said March 18.

  • March 18, 2024

    5th Circuit Majority Denies Ex-NFL Player’s Petition For Rehearing En Banc

    NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals denied a former National Football League (NFL) player’s petition for panel rehearing and the majority of the court denied rehearing en banc, voting 11-5 against rehearing en banc, and issued a substituted opinion on March 15, reiterating that a district court’s ruling in favor of the former player must be reversed because the former player failed to show that he had any changed circumstances that would entitle him to additional disability benefits under the plan.

  • March 15, 2024

    Termination Of LTD Benefits Was Result Of Deliberate Reasoning Process, Panel Says

    CINCINNATI — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s decision was the result of a deliberate and principled reasoning process and was supported by substantial medical evidence, the Sixth Circuit U.S. Court of Appeals said in affirming a district court’s opinion.

  • March 13, 2024

    Oral Surgeon’s Breach Of Contract, Bad Faith Claims Against Disability Insurer Fail

    FRESNO, Calif. — An insured’s breach of contract and bad faith claims against a disability insurer cannot proceed because there is no evidence that any doctor advised the insured to stop working as an oral surgeon to reduce the risk of contracting COVID-19 and suffering complications from the virus based on his comorbid conditions of asthma and hypertension.

  • March 08, 2024

    Claimant Says Additional LTD Benefits Are Owed Under Disability Plan

    PORTLAND, Maine — In a March 7 complaint filed in Maine federal court, a disability claimant maintains that she is entitled to unpaid long-term disability (LTD) benefits under a disability plan because she remains disabled under the terms of the plan.

  • March 08, 2024

    District Court’s Decision Should Be Affirmed, Disability Claimant Maintains

    PHILADELPHIA — A district court’s judgment in favor of a disability claimant should be affirmed because the court properly found that the plan’s termination of the claimant’s long-term disability (LTD) benefits was arbitrary and capricious and that the decision was inadequate for a number of reasons, the claimant says in an appellee brief filed in the Third Circuit U.S. Court of Appeals.

  • March 08, 2024

    Disability Insurer’s Interpretation Of Plan Terms Was Incorrect, Judge Says

    KANSAS CITY, Kan. — A Kansas federal judge granted a disability claimant’s motion for summary judgment after determining that the claimant is owed disability benefits under his employer’s disability plan because the disability insurer’s interpretation of the plan terms regarding eligibility of coverage was incorrect.

  • March 08, 2024

    Disability Claimant Failed To Meet Burden Of Proving Disability, Judge Says

    LAS VEGAS — A disability claimant failed to meet his burden of proving that he was disabled from performing the duties of his regular occupation as an attorney, a Nevada federal judge held after determining that the long-term disability (LTD) insurer engaged in meaningful dialogue with the claimant and did not abuse its discretion in denying the claim for LTD benefits.