Mealey's Disability Insurance

  • 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 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).

  • August 28, 2019

    Denial Of LTD Benefits Was Not Arbitrary Or Capricious, Judge Finds

    CLEVELAND — A disability insurer did not act arbitrarily and capriciously in denying a long-term disability (LTD) benefits claim because the medical evidence did not support a finding that the claimant was entitled to LTD benefits as a result of a heart attack and cognitive problems, an Ohio federal judge said Aug. 21 (Kenneth Radsvick v. United of Omaha Life Insurance Co., No. 18-1872, N.D. Ohio,  2019 U.S. Dist. LEXIS 142060).

  • August 28, 2019

    Disability Insurer Did Not Err In Denying Benefits Under Any-Occupation Standard

    MILWAUKEE — A disability insurer’s denial of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer reasonably concluded that a claimant was not disabled from performing the duties of any occupation, a Wisconsin federal judge said Aug. 26 (Christopher Wilcox v. Aetna Life Insurance Co., No. 18-463, E.D. Wis., 2019 U.S. Dist. LEXIS 144903).

  • August 28, 2019

    Termination Of LTD Benefits Was Reasonable Based On Medical Evidence, Judge Says

    LOUISVILLE, Ky. — A disability insurer did not act arbitrarily or capriciously in terminating a  claimant’s long-term disability (LTD) benefits based on its finding that the claimant was not disabled from working in any occupation because the insurer went to great lengths to ensure that its decision was accurate, a Kentucky federal judge said Aug. 26 (Richard E. Davis v. Hartford Life & Accident Insurance Co., No. 14-507, W.D. Ky., 2019 U.S. Dist. LEXIS 144293).

  • August 21, 2019

    Denial Of STD Benefits Was Not Arbitrary, Capricious, Michigan Federal Judge Says

    DETROIT — The denial of a disability claimant’s short-term disability (STD) claim was not arbitrary and capricious because the plan administrator provided a reasonable explanation for its denial of the claim and the claimant failed to prove that she could not perform the material duties of her own occupation, a Michigan federal judge said Aug. 20 (Mary Savage v. Quicken Loans and Affiliated Companies Welfare Benefits Plan, No. 18-12075, E.D. Mich., 2019 U.S. Dist. LEXIS 140709).

  • August 20, 2019

    Surveillance Video, Medical Report Will Be Included In Administrative Record

    LEXINGTON, Ky. — A Kentucky federal judge on Aug. 15 overruled a disability claimant’s objections to the inclusion of surveillance video, an independent medical report and other documents from the administrative record after determining that the contested video and documents must be included in the record because the insurer relied upon the video and documents when it terminated the claimant’s disability benefits (Jennifer Lee Smith v. Hartford Life and Accident Insurance Co., No. 19-061, E.D. Ky., 2019 U.S. Dist. LEXIS 138152).

  • August 19, 2019

    Insurer Properly Denied Request For Additional LTD Benefits, Judge Says

    HARRISBURG, Pa. — A disability insurer did not act arbitrarily and capriciously in denying a claim for additional long-term disability (LTD) benefits after the claimant exhausted the plan’s 24-month maximum benefit period because the insurer reasonably found that the claimant did not provide objective evidence to support a continuing disability, a Pennsylvania federal judge said Aug. 15 (Brendan Roden-Reynolds v. Metropolitan Life Insurance Co., et al., No. 18-0897, M.D. Pa., 2019 U.S. Dist. LEXIS 137752).

  • August 16, 2019

    Arbitrary, Capricious Standard Of Review Applies, Federal Judge Says

    CHICAGO — An Illinois federal judge on Aug. 15 determined that an arbitrary and capricious standard of review must be applied to a disability dispute because the plan’s discretionary clause is valid and enforceable (Kathleen A. Brubaker v. The Hartford Life and Accident Insurance Co., No. 18-4995, N.D. Ill., 2019 U.S. Dist. LEXIS 137777).