Mealey's Disability Insurance

  • August 06, 2020

    Claimant Met Burden Of Proving She Is Entitled To LTD Benefits For Migraines

    SANTA ANA, Calif. — A California federal judge on July 27 determined that a disability claimant is entitled to long-term disability (LTD) benefits for migraines because the claimant met her burden of proving that migraine headaches prevented her from performing the duties of her own occupation (Amy Olis v. Unum Life Insurance Company of America, No. 19-1347, C.D. Calif., 2020 U.S. Dist. LEXIS 137728).

  • August 06, 2020

    Panel Majority Says Rescission Of Disability Policy Was Not Warranted

    SAN FRANCISCO — The majority of the Ninth Circuit U.S. Court of Appeals panel on Aug. 5 reversed a district court's ruling that a disability insurer was entitled to rescind a policy based on an insured's misrepresentations after determining that the record does not indisputably show that the insured made misrepresentations about his treatment for musculoskeletal problems (Great-West Life & Annuity Insurance Co. v. Michael Harrington, No. 18-55878, 9th Cir., 2020 U.S. App. LEXIS 24656).

  • August 06, 2020

    Disability Insurer Entitled To More Than $30K For Overpayment Of Benefits

    UTICA, N.Y. — A disability insurer is entitled to reimbursement of more than $30,000 for the  overpayment of short-term disability (STD) benefits, a New York federal judge said Aug. 4 after rejecting the plaintiff's argument that the disability insurer failed to properly calculate the amount of benefits owed to the claimant (Susan Penny Vellano v. The Standard Life Insurance Company of New York, et al., No. 18-944, N.D. N.Y., 2020 U.S. Dist. LEXIS 138389).

  • August 05, 2020

    Disability Claimant's Suit Is Barred By Limitations Provision, Judge Says

    DETROIT — A disability claimant's suit seeking long-term disability (LTD) benefits cannot proceed because the suit was filed four days after the disability plan's three-year limitations period expired, a Michigan federal judge said Aug. 4 in granting the disability plan's motion for judgment (Gene Schaf v. Federal Express Corp., d/b/a Federal Express Corp. Long-Term Disability Plan, No. 19-11695, E.D. Mich., 2020 U.S. Dist. LEXIS 138321).

  • July 31, 2020

    Termination Of Benefits Supported By Medical Evidence, Judge Says

    LEXINGTON, Ky. — A Kentucky federal judge on July 29 found that a disability insurer's termination of disability benefits was not arbitrary and capricious because the medical and nonmedical evidence in the administrative record support the insurer's decision (Jennifer Lee Smith v. Hartford Life & Accident Insurance Co., No. 19-61, E.D. Ky., 2020 U.S. Dist. LEXIS 133849).

  • July 30, 2020

    Federal Judge Limits Scope Of Proposed Expert's Testimony In Disability Benefits Suit

    PHOENIX — An Arizona federal judge on July 29 ruled that a disability claimant's proposed insurance expert is not qualified to testify on the claimant's understanding of the disability policy at issue because the testimony would constitute an inadmissible legal conclusion (Thomas Scott Wood v. Provident Life and Accident Insurance Co., No. 17-2330, D. Ariz., 2020 U.S. Dist. LEXIS 134263).

  • July 30, 2020

    Disability Claimant's LTD Benefits Must Be Reinstated, Federal Judge Determines

    SANTA ANA, Calif. — A disability claimant's long-term disability (LTD) benefits must be reinstated because the claimant proved by a preponderance of the evidence that he is disabled from performing the duties of any occupation, a California federal judge said July 27 (Darren Cohen v. Aetna Life Insurance Co., No. 19-1506, C.D. Calif., 2020 U.S. Dist. LEXIS 132818). 

  • July 29, 2020

    Termination Of STD Benefits Was An Abuse Of Discretion, Magistrate Judge Says

    BOISE, Idaho — The termination of a disability claimant's short-term disability (STD) benefits was an abuse of discretion because the decisionto terminate the benefits was not supported by substantial evidence and the medical evidence supported a finding that the claimant remained disabled, an Idaho federal judge said July 27 in granting the claimant's motion for summary judgment (Eric J. Copenhaver v. Baxter International Inc., et al., No. 19-79, D. Idaho, 2020 U.S. Dist. LEXIS 132571).

  • July 28, 2020

    Breach Of Fiduciary Claim In Disability Suit Cannot Proceed, Judge Says

    TAMPA, Fla. — A Florida federal judge on July 24 dismissed a disability claimant's breach of fiduciary allegation against his former employer and disability insurer after determining that the claimant failed to prove that the defendants had a duty to routinely evaluate the disability plan at issue (Lee Fogle v. IBM Corp., et al., No. 19-2896, M.D. Fla., 2020 U.S. Dist. LEXIS 130791).

  • July 23, 2020

    State Law Claims Are Preempted By ERISA, 6th Circuit Panel Affirms

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on July 21 affirmed a district court's dismissal of a disability claimant's suit after determining that the state law claims alleged against the disability insurer are preempted by the Employee Retirement Income Security Act because the allegations are based on the insurer's alleged wrongful denial of benefits (Lorey Lowe v. The Lincoln National Corp., No. 19-6249, 6th Cir.).

  • July 21, 2020

    Termination Of Disability Benefits Was Not Arbitrary Or Capricious, Judge Says

    BATON ROUGE, La. — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because substantial medical evidence supported  the insurer’s finding that the claimant’s hearing loss did not prevent him from working in his own occupation, a Louisiana federal judge said July 20 (Steven W. Caskey v. The Prudential Insurance Company of America, No. 18-694, M.D. La., 2020 U.S. Dist. LEXIS 127254).

  • July 15, 2020

    Disability Claimant's Benefits Were Properly Reduced, 11th Circuit Panel Says

    ATLANTA — The 11th Circuit U.S. Court of Appeals on July 13 affirmed a district court’s ruling that a disability claimant’s monthly disability benefits were properly reduced according to the policy “other income earnings” provision (Stewart S. Richardson Jr. v. Liberty Life Assurance Company of Boston, No. 19-11916, 11th Cir., 2020 U.S. App. LEXIS 21617).

  • July 14, 2020

    Disability Insurer Failed To Timely Make A Decision On LTD Benefits Claim

    OAKLAND, Calif. — A California federal judge on July 6 denied a disability insurer’s motion to  dismiss after agreeing with the disability claimant that the administrative remedies under the plan should be deemed exhausted because the disability insurer failed to timely issue a claim decision as required under the Employee Retirement Income Security Act (Vennessa Hasten v. The Prudential Insurance Company of America, No. 19-7943, N.D. Calif., 2020 U.S. Dist. LEXIS 121897).

  • July 13, 2020

    Disability Claimant’s Suit Against Employer, Insurer Must Be Dismissed, Judge Says

    FORT SMITH, Ark. — An Arkansas federal judge on July 8 dismissed a disability claimant’s suit against her former employer and a disability insurer after determining that a release signed by the claimant prevented her from filing the suit against her employer and that the claimant’s failure to exhaust all her administrative remedies under the disability plan barred her from filing the suit against the disability insurer (Deborah Holmes v. The Prudential Insurance Company of America et al., No. 20-2060, W.D. Ark., 2020 U.S. Dist. LEXIS 119394).

  • July 10, 2020

    Issues Of Fact Exist As To Whether Disability Claimant Could Travel By Airplane

    ALLENTOWN, Pa. — After concluding that issues of fact exist as to whether a disability claimant was unable to travel by airplane, a Pennsylvania federal judge on June 29 denied the parties’ motions for summary judgment and determined that an evidentiary hearing must be scheduled (Glenn W. Forman v. First Unum Life Insurance Co., No. 19-2756, E.D. Pa., 2020 U.S. Dist. LEXIS 113992).

  • July 07, 2020

    Judge Denies Motion To Strike ‘Genuine Dispute’ Affirmative Defense In Disability Suit

    FRESNO, Calif. — A California federal judge on July 6 denied a disability claimant’s motion to strike a disability insurer’s affirmative defense because it would be premature for the court to determine if a genuine issue of material fact exists regarding the claimant’s entitlement to disability benefits (Joni Winburn v. Hartford Life & Accident Insurance Co., No. 19-1397, E.D. Calif., 2020 U.S. Dist. LEXIS 118161).

  • July 07, 2020

    ERISA Clearly Governs Disability Plan, Texas Federal Judge Determines

    TYLER, Texas — A Texas federal judge on July 2 adopted a magistrate judge’s recommendation that a disability insurer’s motion for summary judgment be granted because it is clear from the summary judgment evidence that the disability plan at issue is governed by the Employee Retirement Income Security Act (Steve R. Barnes v. Provident Life and Accident Insurance Co., No. 17-586, E.D. Texas, 2020 U.S. Dist. LEXIS 117658).

  • July 07, 2020

    New York Justice Allows Consumer Fraud Claim To Proceed In Disability Suit

    NEW YORK — A New York Supreme Court justice on June 15 determined that a disability claimant’s bad faith claim must be dismissed because the claim is duplicative of the breach of contract claim; however, the claimant’s consumer fraud claim can proceed because the claimant alleged facts in support of his allegation that the insurer concealed its reasons for denying benefits (John Hunt M.D. v. Metropolitan Life Insurance Co., No. 650718/2019, N.Y. Sup., New York Co., 2020 N.Y. Misc. LEXIS 2814).

  • July 06, 2020

    Medical Consultants Must Be Made Available For Depositions In Disability Dispute

    PHILADELPHIA — A Pennsylvania federal judge on July 2 determined that a disability insurer must make its medical consultants available for depositions because the medical consultants’  opinions are relevant to the issue of whether the disability claimant was disabled and entitled to benefits under the disability plan at issue (Colleen Dwyer v. Unum  Life Insurance Company of America, No. 19-4751, E.D. Pa., 2020 U.S. Dist. LEXIS 116474).

  • July 02, 2020

    8th Circuit Says Evidence Supports Disability Plan’s Denial Of Benefits

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on July 1 affirmed a district court’s ruling that a disability plan’s decision to deny a claimant’s long-term disability (LTD) benefits was reasonable and supported by substantial evidence (Harry DaPron v. Spire Inc. Retirement Plans Committee, No. 19-2166, 8th Cir., 2020 U.S. App. LEXIS 20520).

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