Mealey's Disability Insurance

  • September 26, 2019

    Taxes Must Be Deducted From Disability Claimant’s Settlement, Judge Says

    HUNTINGTON, W.Va.— A West Virginia federal judge on Sept. 25 denied a disability claimant’s motion to enforce a settlement without a deduction for applicable tax withholding after determining that the plan at issue and the Internal Revenue Service require that taxes be withheld from the settlement amount because the settlement clearly qualifies as replacement wages for tax purposes (Noel Jordan v. AT&T Integrated Disability Service Center Disability Plan, et al., No. 18-94, S.D. W.Va., 2019 U.S. Dist. LEXIS 164015).

  • September 26, 2019

    LTD Benefits Must Be Reinstated, Utah Federal Judge Determines

    SALT LAKE CITY — A Utah federal judge on Sept. 24 determined that a disability claimant’s long-term disability (LTD) benefits must be reinstated because the insurer’s termination of benefits was arbitrary and capricious based on the lack of medical evidence to support its termination (Don Foust v. Lincoln National Life Insurance Co., No. 17-1208, D. Utah, 2019 U.S. Dist. LEXIS 164576).

  • September 25, 2019

    Denial Of LTD Benefits Was Arbitrary, Capricious, Federal Judge Determines

    ASHLAND, Ky. — A Kentucky federal judge on Sept. 24 remanded a long-term disability (LTD) claim and life insurance with waiver of premium (LWOP) claim to the disability plan administrator after determining that the  administrator’s termination of LTD and LWOP benefits was arbitrary and capricious (Lewis Bustetter v. Standard Insurance Co., No. 18-1, E.D. Ky., 2019 U.S. Dist. LEXIS 163075).

  • September 24, 2019

    Disability Claimant’s Suit To Remain In Massachusetts, Federal Judge Says

    WORCESTER, Mass. — A Massachusetts federal judge on Sept. 20 denied a motion to transfer a disability claimant’s suit to Kansas federal court after determining that the disability insurer defendants failed to prove that private or public interest factors weigh in favor of transferring the case (Mary MacNaughton v. Paul Revere Life Insurance Co. & Unum Group, No. 19-40016, D. Mass., 2019 U.S. Dist. LEXIS 160454).

  • September 23, 2019

    Insured’s Claims Related To Disability Payment Are Barred By Statute Of Limitations

    SAN DIEGO — A California federal judge on Sept. 17 granted an insurer’s motion for judgment on the pleadings after determining that an insured’s claims related to an alleged missed disability income payment are barred by the applicable statute of limitations (Renato Openiano v. Hartford Life and Annuity Insurance Co., et al., No. 18-943, S.D. Calif., 2019 U.S. Dist. LEXIS 160005).

  • September 20, 2019

    Disability Claimant Provided Final Opportunity To File Summary Judgment Response

    SACRAMENTO, Calif. — A California federal magistrate judge on Sept. 17 denied a disability insurer’s motion to grant summary judgment on a disability claimant’s remaining claims based on the claimant’s failure to file a response to the insurer’s motion and allowed the claimant one final opportunity to file a response after determining that an extension is warranted based on the claimant’s pro se status (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2019 U.S. Dist. LEXIS 159246).

  • September 19, 2019

    Disability Claimant’s Opinions Are Not Relevant To Breach Of Contract Claim, Judge Says

    WILLIAMSPORT, Pa. — A Pennsylvania federal judge on Sept. 17 determined that a disability claimant’s opinions on the handling of his claim must be excluded from trial because the claimant’s opinions are not relevant to the breach of contract claim and would be prejudicial to the disability insurer and that the claimant’s expert witnesses cannot testify as to whether the claimant is disabled from his own occupation as a dentist because the experts do not have sufficient knowledge of the claimant’s occupational duties (Dr. Robert Brugler v. Unum Group, et al., No. 15-1031, M.D. Pa., 2019 U.S. Dist. LEXIS 158503).

  • September 18, 2019

    Extra-Record Discovery Request Granted In Disability Dispute

    GREENBELT, Md. — A Maryland federal judge on Sept. 5 issued a letter order granting a disability claimant’s motion for extra-record discovery after determining that the claimant met her burden of establishing that the administrative record does not provide sufficient evidence to address her claim that the disability insurer’s termination of benefits was affected by a conflict of interest (Holly Chughtai v. Metropolitan Life Insurance Co., No. 19-848,  D. Md., 2019 U.S. Dist. LEXIS 154304).

  • September 16, 2019

    Federal Judge Reinstates LTD Benefits, Says Insurer’s Termination Is Not Supported

    AKRON, Ohio — An Ohio federal judge on Sept. 11 reinstated a disability claimant’s long-term disability (LTD) benefits after determining that the termination of her benefits was arbitrary and capricious because the insurer selectively reviewed the medical evidence to support its denial (Kristina Rossiter v. Life Insurance Company of North America, No. 18-1421, N.D. Ohio, 2019 U.S. Dist. LEXIS 155126).

  • September 13, 2019

    6th Circuit Vacates, Remands Disability Suit, Says District Court Lacked Jurisdiction

    CINCINNATI — A district court erred in denying a disability claimant’s motion to remand because the amount in controversy did not exceed the federal jurisdictional minimum amount of $75,000, the Sixth Circuit U.S. Court of Appeals said Sept. 11 in vacating and remanding the district court’s ruling in favor of a disability insurer (Linda Graves v. Standard Insurance Co., No. 18-5449, 6th Cir., 2019 U.S. App. LEXIS 27526).

  • September 13, 2019

    Employer’s Complaint Dismissed; Finding Already Made On ERISA’s Applicability

    SEATTLE — A Washington federal judge on Sept. 10 dismissed an employer’s complaint seeking a finding that its short-term disability (STD) plan is not governed by the Employee Retirement Income Security Act because the issue already was decided by the director of the Washington State Department of Labor and Industries and cannot be relitigated in federal court (Phillips 66 Co., et al., v. Joel Sacks, et al., No. 19-174, W.D. Wash., 2019 U.S. Dist. LEXIS 154155).

  • September 12, 2019

    2nd Circuit Affirms Attorney Fee Award, Finds No Abuse Of Discretion In Reduced Award

    NEW YORK — The Second Circuit U.S. Court of Appeals on Sept. 10 affirmed a district court’s award of attorney fees to a disability claimant after determining that the lower court did not err in reducing the hourly rate for the award of attorney fees because the claimant’s counsel failed to show that the requested hourly rates are the prevailing rates for the district in which the law firm is located (Janet Solnin v. Sun Life and Health Insurance Co., et al., No. 18-3042, 2nd Cir., 2019 U.S. App. LEXIS 27199).

  • September 12, 2019

    Florida Federal Judge Allows Bad Faith Claim In Disability Dispute To Proceed

    WEST PALM BEACH, Fla. — A Florida federal judge on Sept. 9 determined that a bad faith claim can proceed in a disability and life insurance dispute because the plaintiffs seeking benefits under the policies sufficiently alleged facts to support the bad faith claim (Douglas Kuber v. Berkshire Life Insurance Company of America, No. 19-80211, S.D. Fla., 2019 U.S. Dist. LEXIS 154379). 

  • September 11, 2019

    8th Circuit Panel Says Disability Suit Properly Removed To Federal Court

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Sept. 10 affirmed a district court’s denial of a disability claimant’s motion to remand because the disability insurer properly notified the state court about the removal to federal court (Roger Brooks v. Liberty Life Assurance Company of Boston, No. 18-2612, 8th Cir., 2019 U.S. App. LEXIS 27226).

  • September 09, 2019

    Federal Magistrate Judge Recommends Dismissal Of Former NFL Player’s Suit

    NEW YORK — A New York federal magistrate judge on Sept. 5 recommended dismissing a former National Football League player’s complaint after determining that the player failed to provide support for allegations that the NFL’s retirement plan and its fiduciaries duty violated the Employee Retirement Income Security Act by refusing to reclassify players’ disability benefits as football degenerative (FD) benefits despite evidence showing that the disabilities suffered by players were caused by numerous hits to the head and concussions sustained while playing in the NFL (Christopher Hudson, et al. v. National Football League Management Council, et al., No. 18-4483, S.D. N.Y., 2019 U.S. Dist. LEXIS 152545).

  • September 09, 2019

    Disability Claimant Seeks High Court Review On Meaning Of ‘Regular Occupation’

    WASHINGTON, D.C. — The U.S. Supreme Court should review the Fifth Circuit U.S. Court of Appeals’ ruling in favor of a disability insurer on the insurer’s interpretation of the term “regular occupation” to resolve the conflict among circuit courts regarding the proper interpretation of the term, a disability claimant asserts in an Aug. 21 petition for writ of certiorari  (Juanita Nichols v. Reliance Standard Life Insurance Co., No. 19-242, U.S. Sup.).

  • September 05, 2019

    Former NFL Player Says Denial Of Disability Benefits Was Abuse Of Discretion

    SAN FRANCISCO — A former National Football League player seeking total and permanent (T&P) disability benefits under the NFL’s retirement plan claims in an Aug. 26 suit filed in California federal court that the plan abused its discretion by refusing to pay him T&P benefits (Charles Dimry v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, et al., No. 19-5360, N.D. Calif.)

  • September 05, 2019

    ERISA Preempts State Law Claims Against Disability Insurer, Judge Says

    LAS VEGAS — A Nevada federal judge on Sept. 3 granted a disability insurer’s motion to  dismiss after determining that the disability claimant’s state law claims are preempted by the Employee Retirement Income Security Act; however, the judge granted the disability claimant leave to amend the complaint to add factual allegations in support of the argument that ERISA’s governmental exception applies as a bar to preemption  (Michael Gray v. Reliance Standard Life Insurance Co., No. 18-1551, D. Nev., 2019 U.S. Dist. LEXIS 149226).

  • September 04, 2019

    LTD Benefits Denial Based On Pre-Existing Conditions Exclusion Was Arbitrary

    BOSTON — The First Circuit U.S. Court of Appeals on Sept. 3 affirmed a district court’s judgment in favor of a disability claimant after determining that the disability insurer’s denial of benefits based on the plan’s pre-existing conditions exclusion was arbitrary and capricious (John Lavery v. Restoration Hardware Long Term Disability Benefits Plan, et al,, Nos. 18-1885, 18-2027, 1st Cir., 2019 U.S. App. LEXIS 26578).

  • August 29, 2019

    Termination Of Benefits Was Arbitrary, Capricious, Pennsylvania Federal Judge Says

    ALLENTOWN, Pa. — A disability insurer’s termination of benefits was arbitrary and capricious because the insurer failed to provide reliable evidence supporting its decision and the insurer rejected the opinion of the claimant’s treating physician without providing a reason for doing so, a Pennsylvania federal judge said Aug. 27 in granting judgment in favor of the disability claimant (Leo Noga v. Reliance Standard Life Insurance Co., No. 18-3455, E.D. Pa., 2019 U.S. Dist. LEXIS 145227).

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