DENVER — A disability insurer acted arbitrarily and capriciously in failing to request additional evidence from a disability claimant and in failing to conduct an independent medical exam because there was evidence suggesting that the claimant was still disabled when the insurer terminated her benefits, a Colorado federal magistrate judge said April 25 in recommending that the insurer’s denial of benefits be reversed (Julia Mark v. Aetna Life Insurance Co., et al., No. 17-441, D. Colo., 2018 U.S. Dist. LEXIS 69561).
NEW ORLEANS — A Louisiana federal magistrate judge on April 23 determined that a disability insurer must supplement its answers to a disability claimant’s interrogatories regarding compensation paid to attorneys and physicians who advised the disability insurer during the administration of the plan participant’s claim, but said the disability insurer is not required to produce information regarding previously investigated and adjusted claims (Anne Wittmann v. Unum Life Insurance Company of America, No. 17-9501, E.D. La., 2018 U.S. Dist. LEXIS 68145).
SPRINGFIELD, Mass. — A disability claimant is permitted to supplement the administrative record with information from a disability insurer’s claims manual pertaining to the handling of vocational analyses and subjective pain complaints because the information is relevant to the review of the claimant’s long-term disability benefits claim, a Massachusetts federal magistrate judge said April 23 (Natalya Prohkorova v. Unum Life Insurance Company of America, No. 17-30064, D. Mass., 2018 U.S. Dist. LEXIS 67548).
JACKSON, Miss. — A Mississippi federal judge on April 19 granted a disability insurer’s motion to dismiss a disability claimant’s suit on the basis that the claimant failed to file suit within the three-year limitations period provided for in the policy (Alexander Williams v. Hartford Life & Accident Insurance Co., No. 17-927, S.D. Miss., 2018 U.S. Dist. LEXIS 65881).
PORTLAND, Ore. — An Oregon federal judge on April 17 granted a disability claimant’s motion to file the entire administrative record under seal after determining that the claimant’s interest in keeping her personal and medical information private outweighs the right of public access to the information (Alison Gary v. Unum Life Insurance Company of America, No. 17-1414, D. Ore., 2018 U.S. Dist. LEXIS 64186).
LAFAYETTE, La. — A Louisiana federal magistrate judge on April 13 dismissed a disability claimant’s suit seeking benefits after determining that the claims against the disability insurer cannot stand because the insurer eventually awarded the claimant short-term disability and long-term disability benefits (Jack V. Venable Jr. v. Schlumberger Technology Corp., et al., No. 16-01336, W.D. La., 2018 U.S. Dist. LEXIS 63101).
JOHNSTOWN, Pa. — A Pennsylvania federal judge on March 28 dismissed a disability claimant’s suit arising out of an offset applied to long-term disability benefits because the policy at issue clearly allows the insurer to offset benefits by the amount of benefits the claimant’s children receive from the Social Security Administration (Anthony Patchell et al., v. Cigna Health and Life Insurance Co., et al., No. 17-161, W.D. Pa.).
GREENSBORO, N.C. — A North Carolina federal judge on March 26 determined that a disability claimant’s breach of contract allegations are preempted by the Employee Retirement Income Security Act because the claimant is suing to recover benefits under plans governed by ERISA (Stacie Lawrence v. Randolph Hospital Inc., No. 17-363, M.D. N.C.).
NEW YORK — The Second Circuit U.S. Court of Appeals on April 12 reversed a district court’s dismissal of a suit filed by individuals seeking reimbursement of premiums paid for accidental disability policies after determining that the plaintiffs have standing to assert the claims against the issuers of the policies (Manette DuBuisson, et al. v. Stonebridge Life Insurance Co., et al., No. 16-3526, 2nd Cir., 2018 U.S. App. LEXIS 9180).
CINCINNATI — The Sixth Circuit U.S. Court of Appeals on April 13 affirmed a district court’s ruling in favor of a disability insurer after determining that the disability claimant’s suit seeking long-term disability benefits fails because the claimant did not exhaust all administrative remedies before filing suit (William Kennedy v. Life Insurance Company of North America, No. 17-5901, 6th Cir., 2018 U.S. App. LEXIS 9214).
DES MOINES, Iowa — An Iowa federal magistrate judge on April 9 recommended granting judgment in favor a disability insurer because the plan’s pre-existing condition provision bars benefits for an eye condition that caused the claimant’s blindness (Jeremy J. Timm v. Unum Life Insurance Company of America, No. 17-3019, N.D. Iowa, 2018 U.S. Dist. LEXIS 59522).
SALT LAKE CITY — A Utah federal judge on March 29 granted a disability insurer’s motion for summary judgment after determining that the insurer’s denial of short-term disability benefits was supported by substantial medical evidence (Shawna Jennings v. Hartford Life and Accident Insurance Co., et al., No. 15-683, D. Utah, 2018 U.S. Dist. LEXIS 55016).
CINCINNATI — The Sixth Circuit Court of Appeals on March 30 remanded a claim for short-term disability (STD) benefits to the plan administrator for a full and fair review of the claim because the plan administrator’s refusal to conduct an in-person medical exam was arbitrary and capricious (Kimberly J. Guest-Marcotte v. Life Insurance Company of North America, et al., No. 17-1233, 6th Cir., 2018 U.S. App. LEXIS 8105).
COLUMBUS, Ohio — A disability administrator’s denial of benefits to a claimant for a diagnosis autism spectrum disorder is supported by substantial evidence in the administrative record, an Ohio federal judge said March 27, noting that the administrator’s denial was based on a deliberate and principled reasoning process (John R. Chartkoff v. American Electric Power, et al., No. 16-1186, S.D. Ohio, 2018 U.S. Dist. LEXIS 50762).
MINNEAPOLIS — A disability insurer cannot assert that the attorney-client privilege applied to a number of withheld documents because the communications arising out of a claimant’s request for plan documents were a matter of plan administration and fall under the fiduciary exception, a Minnesota federal magistrate judge said March 15 (Michael Christoff v. Unum Life Insurance Company of America, No. 17-3512, D. Minn., 2018 U.S. Dist. LEXIS 43535).
RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals on March 28 agreed with a district court that a disability insurer’s decision to terminate a claimant’s partial disability benefits was reasonable because the insurer worked with the claimant when prorating the claimant’s quarterly bonus and the claimant did not object to the method used by the insurer to prorate the bonus (Frederick Sutherland v. Sun Life Assurance Company of Canada, No. 17-1293, 4th Cir., 2018 U.S. App. LEXIS 7761).
CHICAGO — A man who suffering from invasive basal cell carcinoma in the right ear tells the Seventh Circuit U.S. Court of Appeals in a Jan. 19 brief that a federal judge in Illinois erred when finding that he was not entitled to total disability benefits from his insurer because he cannot complete the duties that his work requires (Henry Fiorentini v. Paul Revere Life Insurance Co., No. 17-3137, 7th Cir.).
CINCINNATI — The majority of the Sixth Circuit U.S. Court of Appeals on March 26 determined that a disability plan administrator did not deprive a disability claimant of a full and fair review under the Employee Retirement Income Security Act because the administrator consulted with more than one physician before denying the claimant’s appeal (Katherine Castor v. The AT&T Umbrella Benefit Plan No. 3, No. 17-3400, 6th Cir., 2018 U.S. App. LEXIS 7494).
ST. LOUIS — A Missouri federal judge on March 23 determined that a disability claimant cannot recover damages from a disability insurer for failure to produce requested plan documents because the insurer was not the plan administrator (Rebecca Dunivin v. Life Insurance Company of North America, et al., No. 17-1530, E.D. Mo., 2018 U.S. Dist. LEXIS 48164).
LYNCHBURG, Va. — A disability insurer did not abuse its discretion in terminating a claimant’s long-term disability (LTD) benefits because the evidence supports the insurer’s conclusion that the claimant was not disabled as an engineer under the plan’s any-occupation standard, a Virginia federal judge said March 23 (Melvin Moore v. Life Insurance Company of North America, No. 17-030, W.D. Va., 2018 U.S. Dist. LEXIS 48313).