Mealey's Disability Insurance

  • February 28, 2020

    Arizona Disability Claimant Denied Discovery Into Alleged Conflicts Of Interest

    PHOENIX — A federal judge in Arizona on Feb. 25 denied a disability claimant’s request for discovery to supplement the administrative record in her suit alleging that her claim for long-term disability (LTD) was wrongfully denied, finding that she failed to demonstrate that the insurer’s alleged structural conflict of interest demands additional discovery or that information she sought about its medical reviewers’ alleged conflicts would be necessary for the court to conduct a de novo review (Leslie DeMarco v. Life Insurance Company of North America, et al., No. CV-19-02385, D. Ariz., 2020 U.S. Dist. LEXIS 31723).

  • February 20, 2020

    3rd Circuit Upholds Ruling For Disability Plan Administrator In Benefits Denial Suit

    PHILADELPHIA — The administrator of a short-term disability (STD) and a long-term disability (LTD) plan did not abuse its discretion in violation of the Employee Retirement Income Security Act when it denied both types of benefits to a employee who claimed that she couldn’t work due to headaches but was found by the administrator’s doctors and her own to be able to control her symptoms with medication, a Third Circuit U.S. Court of Appeals panel ruled Feb. 18 (Anna Ackaway v. Aetna Life Insurance Company, No. 16-3969, 3rd Cir., 2020 U.S. App. LEXIS 4946).

  • February 14, 2020

    Attorney Fees, Costs Awarded To Disability Claimant Who Achieved Some Success On Merits

    NEW HAVEN, Conn. — A Connecticut federal judge on Feb. 5 awarded a disability claimant more than $100,000 in attorney fees after determining that the award is warranted because the claimant achieved some success on the merits when her claim was remanded to the disability plan administrator for a full and fair review (Patricia Hughes v. Hartford Life and Accident Insurance Co., No. 17-1561, D. Conn., 2020 U.S. Dist. LEXIS 18812).

  • February 13, 2020

    STD Benefits Properly Terminated As Claimant Was No Longer An Employee

    ANNISTON, Ala. — An Alabama federal judge on Feb. 12 denied a disability claimant’s motion for judgment after determining that the claimant’s short-term disability (STD) benefits were properly terminated when the claimant was removed from his employer’s payroll and was no longer an employee of the company (Jeffrey Washburn v. AT&T Umbrella Benefit Plan #1, et al., No. 18-647, N.D. Ala., 2020 U.S. Dist. LEXIS 24616).

  • February 11, 2020

    Disability Claimant Cannot Use Evidence Outside Of Administrative Record

    NEW ORLEANS — A Louisiana federal judge on Feb. 10 determined that a disability claimant is not permitted to introduce evidence from outside of the administrative record because the claimant failed to prove that any exception exists to warrant consideration of the evidence (Kim Williams Bayer v. Unum Life Insurance Company of America, et al., No. 18-9702, E.D. La., 2020 U.S. Dist. LEXIS 22250).

  • February 11, 2020

    Disability Insurer’s Denial Of LTD Benefits Was Reasonable, Judge Says

    ALEXANDRIA, Va. — A Virginia federal judge on Jan. 31 granted summary judgment in favor of a disability insurer after determining that the disability insurer’s denial of long-term disability (LTD) benefits was reasonable based on the medical evidence (Robin Thomas v. Aetna Life Insurance Co., No. 19-611, E.D. Va., 2020 U.S. Dist. LEXIS 19843).

  • February 06, 2020

    Federal Judge Says Fact Issues Exist On Disability Claimant’s Occupational Duties

    PHOENIX — An Arizona federal judge on Feb. 3 determined that questions of fact exist as to whether a disability claimant is able to perform the material duties of a clinical anesthesiologist and whether the disability insurer’s handling of the disability claim constitutes bad faith (Thomas Scott Wood v. Provident Life and Accident Insurance Co., No. 17-2330, D. Ariz., 2020 U.S. Dist. LEXIS 19057).

  • February 06, 2020

    Disability Insurer Failed To Consider Opinions Of Treating Physicians

    AKRON, Ohio — An Ohio federal magistrate judge on Jan. 31 granted a disability claimant’s motion for judgment on the administrative record and remanded the long-term disability (LTD) benefits claim to the plan administrator after determining that the plan administrator failed to consider the opinions of two of the claimant’s treating physicians (Ann M. Geraci v. Hartford Life and Accident Insurance Co., No. 18-2367, N.D. Ohio, 2020 U.S. Dist. LEXIS 16142).

  • February 05, 2020

    Disability Insurer’s Termination Of Benefits Supported By Evidence

    COLUMBUS, Ohio — An Ohio federal judge on Feb. 4 granted a disability insurer’s motion for judgment on the administrative record after determining that the evidence clearly supported the insurer’s decision to terminate a claimant’s long-term disability benefits (Farron Russell Creed v. Hartford Life & Accident Co., No. 19-1072, S.D. Ohio, 2020 U.S. Dist. LEXIS 17613).

  • February 04, 2020

    Disability Claimant Did Not Meet Burden Of Proof, Appeals Panel Affirms

    CHICAGO — The Seventh Circuit U.S. Court of Appeals on Feb. 3 affirmed a district court’s ruling in favor of a disability insurer after determining that the lower court did not abuse its discretion by limiting its review of a long-term disability (LTD) benefits claim to the administrative record before the court (Stephanie Dorris v. Unum Life Insurance Company of America, No. 19-1701, 7th Cir., 2020 U.S. App. LEXIS 3206).

  • February 04, 2020

    Disability Insurer’s Claims Dismissed; Economic Loss Rule Precludes Claims

    WEST PALM BEACH, Fla. — A Florida federal judge on Jan. 27 dismissed a disability insurer’s counterclaims for fraud and negligent misrepresentation in a disability and life insurance dispute because the counterclaims are barred by the economic loss rule (ELR), which prohibits tort claims in a contractual dispute (Douglas Kuber v. Berkshire Life Insurance Company of America, No. 19-80211, S.D. Fla., 2020 U.S. Dist. LEXIS 14121).

  • February 03, 2020

    Disability Insurer’s Denial Of Benefits Was Not Reasonable, Panel Says

    ATLANTA — A district court did not err in entering summary judgment in favor of a disability claimant because the evidence supports a finding that the claimant is disabled from practicing as a dentist, the 11th Circuit U.S. Court of Appeals said Jan. 31 (Kia Kaviani, D.M.D. v. Reliance Standard Life Insurance Co., No. 19-11798, 11th Cir., 2020 U.S. App. LEXIS 3006).

  • January 29, 2020

    Disability Claimant Met Burden Of Proving Disability, 6th Circuit Panel Says

    CINCINNATI — The Sixth Circuit U.S. Court of Appeal on Jan. 23 reversed a district court’s ruling in favor of a disability plan after determining that the disability claimant proved by a preponderance of the evidence that he was disabled from performing the duties of his regular occupation and that he was under the regular care of a physician for his disabling conditions (Jesse Bruton v. American United Life Insurance Corp., No. 19-3466, 6th Cir., 2020 U.S. App. LEXIS 2498).

  • January 28, 2020

    Disability Insurer Properly Offset Claimant’s Veterans Affairs’ Benefits, Panel Says

    BOSTON — The First Circuit U.S. Court of Appeals on Jan. 27 affirmed a district court’s ruling in favor of a disability insurer after determining the lower court did not err in finding that the disability insurer properly offset disability benefits payable under its policy by disability benefits received by the claimant from the U.S. Department of Veterans Affairs (Marco Martinez v. Sun Life Assurance Company of Canada, No. 18-2127, 1st Cir., 2020 U.S. App. LEXIS 2507).

  • January 27, 2020

    Disability Claimant’s Suit Against Insurer Dismissed As Untimely By Federal Judge

    NEW ORLEANS — A disability claimant’s complaint must be dismissed because the claimant failed to file suit against the disability insurer within three years as required by the disability plan’s applicable and enforceable contractual limitation period, a Louisiana federal judge said Jan. 24 (Gregory Scott Sr. v. The Prudential Insurance Company of America, No. 19-9294, E.D. La., 2020 U.S. Dist. LEXIS 12299).

  • January 27, 2020

    Panel Says Fraud Act Claim Alleged By Disability Claimant Cannot Stand

    NEW YORK — A trial court erred in denying a disability insurer’s motion to dismiss a claim alleging violation of New Jersey's Consumer Fraud Act (NJCFA) because a wrongful denial of benefits claim is not actionable under the NJCFA and the claimant failed to allege any deceitful conduct related to the procurement or issuance of the disability policy, the First Department of the New York Supreme Appellate Division said Jan. 23 (Yochanan Bulka v. Metropolitan Life Insurance Co., No. 657560/17, N.Y. Sup., App. Div., 1st Dept., 2020 N.Y. App. Div. LEXIS 470).

  • January 24, 2020

    De Novo Standard Of Review To Be Applied In Disability Benefits Dispute

    MOBILE, Ala. — A de novo standard of review must be applied in a disability benefits dispute because the disability insurer failed to provide the claimant with a full and fair review as required by the Department of Labor regulations governing disability claims, an Alabama federal judge said Jan. 21 in granting a disability claimant’s motion for partial summary judgment (Brian McConnell v. American General Life Insurance Co., No. 19-0174, S.D. Ala., 2020 U.S. Dist. LEXIS 9605).

  • January 24, 2020

    Disability Claimant’s Suit Remanded To Kansas State Court; Federal Claim Dismissed

    KANSAS CITY, Kan. — A Kansas federal judge on Jan. 23 remanded a disability benefits dispute to Kansas state court after determining that the only federal claim asserted by the claimant must be dismissed for failure to state a claim (Sheila Hunnell Villines v. Hartford Life and Accident Insurance Co., No. 19-2581, D. Kan., 2020 U.S. Dist. LEXIS 11053).

  • January 21, 2020

    Claimant Was Not Disabled Under Any-Occupation Standard, Panel Concludes

    SAN FRANCISCO — 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 finding that the claimant was not totally disabled from performing the duties of any occupation, the Ninth Circuit U.S. Court of Appeals said Jan. 16 (Dyel O. Talbot v. Reliance Standard Life Insurance Co., et al., No. 18-15375, 9th Cir., 2020 U.S. App. LEXIS 1657).

  • January 17, 2020

    9th Circuit Denies Petition For Rehearing In Disability, Standard Of Review Suit

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Jan. 15 denied a disability claimant’s motion for rehearing en banc, refusing to reconsider its ruling that a district court did not err in applying an abuse-of-discretion standard of review in a disability suit because the plan administrator’s conduct did not rise to the level of requiring a de novo review of the plan’s denial of benefits (Olga Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., Nos. 18-15400, 18-16178, 9th Cir., 2020 U.S. App. LEXIS 1376).

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