JACKSON, Miss. — Noting that a disability insurer engaged in a “decades-long pattern of arbitrary claim denials and other misdeeds,” a Mississippi federal judge on June 29 determined that the insurer’s denial of benefits to a claimant was an abuse of discretion because the denial was unsupported by the evidence (Juanita Nichols v. Reliance Standard Life Insurance Co., No. 17-42, S.D. Miss., 2018 U.S. Dist. LEXIS 109526).
NEW YORK — A New York state court judge on June 18 ruled that it is too early to determine whether an insured is entitled to an award of attorney fees in an insurance breach of contract and bad faith lawsuit because the trial court has yet to decide whether an insurer’s actions rose to the level of bad faith (Eric Schneck v. First Unum Life Insurance Co., No. 155800/2012, N.Y. Sup., New York Co., 2018 N.T. Misc. LEXIS 2456).
BOSTON — A Massachusetts federal judge on June 28 reduced an award of attorney fees to a disability claimant after determining that a number of the hours billed by the claimant’s attorney are not compensable because the hours were related to alleged misrepresentations made by the claimant’s attorney (Diahann L. Gross v. Sun Life Assurance Company of Canada, No. 09-11678, D. Mass., 2018 U.S. Dist. LEXIS 107918).
By Vivian Cullipher
DENVER — A panel of the 10th Circuit U.S. Court of Appeals on May 15 heard oral arguments in a case in which a man contends that the insurer that denied his claim for long-term disability (LTD) had a conflict of interest and its decision to deny his benefits on the basis of the pre-existing condition limitation was “arbitrary and capricious” (Michael Green v. Life Insurance Company of North America, No. 17-1383, 10th Cir.).
MONTGOMERY, Ala. — An Alabama federal judge on June 22 vacated a judgment entered in favor of a disability insurer and granted the disability claimant’s motion to amend his complaint to state a claim under the Employee Retirement Income Security Act after determining that failing to vacate the prior judgment would result in a manifest injustice against the claimant (Charles M. Davis v. The Prudential Insurance Company of America, No. 14-43, M.D. Ala., 2018 U.S. Dist. LEXIS 104462).
SAN FRANCSICO — The Ninth Circuit U.S. Court of Appeals on June 21 affirmed a district court’s award of own-occupation long-term disability (LTD) benefits in favor of a disability claimant but vacated and remanded the lower court’s award of attorney fees in favor of the claimant for recalculation (Dave Nagy v. Group Long Term Disability Plan for Employees of Oracle America Inc., et al., Nos. 16-16160, 17-15491, 9th Cir., 2018 U.S. App. LEXIS 16883).
DENVER — A disability insurer did not act arbitrarily or capriciously in denying a plan participant’s claim for long-term (LTD) disability benefits because the insurer’s denial was supported by substantial evidence, the 10th Circuit U.S. Court of Appeals said June 21 (John Dardick v. Unum Life Insurance Company of America, et al., No. 17-1412, 10th Cir., 2018 U.S. App. LEXIS 16753).
CHICAGO — The Seventh Circuit U.S. Court of Appeals on June 21 affirmed a district court’s ruling that a disability claimant suffering from invasive basal cell carcinoma in the right ear is not entitled to total disability benefits from his insurer because he is still able to perform all but one of the functions of his occupation as a company president (Henry Fiorentini v. Paul Revere Life Insurance Co., No. 17-3137, 7th Cir., 2018 U.S. App. LEXIS 16741).
ST. LOUIS — A Missouri federal judge on June 19 remanded a long-term disability (LTD) claim and instructed the claims administrator to evaluate if the side effects of the claimant’s prescribed medications affected the claimant’s ability to perform any occupation (Lisa Conner v. Ascension Health, et al., No. 17-021, E.D. Mo., 2018 U.S. Dist. LEXIS 102064).
SAN FRANCISCO — A disability claimant is entitled to long-term disability (LTD) benefits because the evidence from the claimant’s treating physicians and evidence obtained from the disability insurer’s medical reviewers support a finding that the claimant is disabled under the plan’s any-occupation standard, a California federal judge said June 18 (Sarabjit Sangha v. Cigna Life Insurance Company of New York, No. 17-5158, N.D. Calif., 2018 U.S. Dist. LEXIS 101725).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on June 15 remanded a disability benefits dispute to the district court to determine whether the claimant is entitled to equitable relief based on the disability plan’s failure to properly offset the claimant’s disability benefits (Petar Mrkonjic v. Delta Family-Care and Survivorship Plan, et al., Nos. 16-56335, No. 16-56487, 9th Cir., 2018 U.S. App. LEXIS 16162).
NEW ORLEANS — A Louisiana federal judge on June 12 granted a disability plan administrator’s motion for summary judgment after determining that the disability claimant’s suit must be dismissed because the claimant failed to file suit within the disability plan’s limitations period (Michael Faciane v. Sun Life Assurance Company of Canada, No. 17-17429, E.D. La., 2018 U.S. Dist. LEXIS 97969).
NEW ORLEANS — A Louisiana federal judge on June 13 ordered a disability insurer to supplement its answers to a disability claimant’s interrogatories to include communications with all attorneys consulted regarding the participant’s claim for benefits (Anne Wittmann v. Unum Life Insurance Company of America, No. 17-9501, E.D. La., 2018 U.S. Dist. LEXIS 99042).
WASHINGTON, D.C. — The U.S. Supreme Court should grant 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 has widened an existing conflict between federal courts of appeal regarding whether a benefit plan governed by the Employee Retirement Income Security Act is a proper defendant, the petitioners argue in their May 11 brief filed in the high court (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., 2018 U.S. S. Ct. Briefs LEXIS 1932).
RICHMOND, Va. — A North Carolina woman is asking the Fourth Circuit U.S. Court of Appeals to reverse a lower court’s ruling regarding her disability insurance coverage claim because benefit increases that she purchased on her policy were wrongly retracted when the insurer initially denied her claim and then later elected to pay benefits to a retroactive date (Jessica Slice-Sadler v. Principal Life Insurance Company, No. 17-2249, 4th Cir.).
BIRMINGHAM, Ala. — An Alabama federal judge on May 30 granted a disability insurer’s motion to dismiss a claimant’s breach of fiduciary duty claim after determining that the claim seeking recovery of benefits under the Employee Retirement Income Security Act provides an adequate remedy to the claimant (Carol H. Stewart v. Hartford Life & Accident Insurance Co., No. 17-1423, N.D. Ala., 2018 U.S. Dist. LEXIS 89508).
SACRAMENTO, Calif. — A California federal judge on June 4 recommended dismissing a disability claimant’s state law claims because the state law claims are preempted under the Employee Retirement Income Security Act (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2018 U.S. Dist. LEXIS 93784).
WASHINGTON, D.C. — A District of Columbia federal judge on June 6 dismissed claims alleging that a short-term disability (STD) insurance provider violated the Employee Retirement Income Security Act by engaging in prohibited transactions after determining that the plan’s trustees failed to prove that the insurer engaged in any transactions that are prohibited under ERISA (Joseph Sellers Jr., et al., v. Anthem Life Insurance Co., No. 16-2428, D. D.C., 2018 U.S. Dist. LEXIS 95278).
DETROIT — A Michigan federal judge on June 1 upheld a magistrate judge’s order permitting a disability claimant to conduct limited discovery on the number of times a disability insurer employed a specific doctor to complete medical reviews of long-term disability claims because the claimant made “a sufficient predicate showing” to warrant the limited discovery (Precious Robert Johnson v. Harleysville Life Insurance Co., No. 17-10321, E.D. Mich., 2018 U.S. Dist. LEXIS 92833).