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Mealey's Disability Insurance

  • July 17, 2018

    LTD Insurer Wrongfully Applied Pre-Existing Condition Exclusion, Insured Says

    NEW YORK — A disability insurer wrongfully denied a claim for long-term disability (LTD) benefits based on the plan’s pre-existing condition exclusion because the claimant’s diagnosis of attention deficit hyperactivity disorder during the 90-day period prior to becoming insured was not a misdiagnosis of the claimant’s later diagnosis of bipolar disorder, the condition for which LTD benefits were sought, the claimant says in a July 2 complaint filed in New York federal court (Aaron Slavutin v. Standard Insurance Co., No. 18-5994, S.D. N.Y.).

  • July 11, 2018

    Disability Claimant’s Suit Was Properly Dismissed, 6th Circuit Panel Says

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on July 9 affirmed the dismissal of a disability claimant’s suit after determining that the claimant failed to provide support for the state law claims that were not preempted under the Employee Retirement Income Security Act (Surrinder Arora v. Henry Ford Health System, et al., No. 17-2252, 6th Cir., 2018 U.S. App. LEXIS 18712).

  • July 11, 2018

    Panel Vacates, Remands Disability Award For Recalculation Of Benefits

    ATLANTA — A district court did not err in determining that a disability claimant abandoned his bad faith claims against a disability insurer, but  the court did err in interpreting the disability insurer’s continuity of coverage policy provision, the 11th U.S. Court of Appeals said July 10 in vacating and remanding an award of benefits for recalculation (Wayne Torpy v. Unum Life Insurance Company of America, No. 17-14722, 11th Cir., 2018 U.S. App. LEXIS 18669).

  • July 6, 2018

    Professional Hockey Player’s Claims Preempted Under ERISA, Federal Judge Says

    DALLAS —  A Texas federal judge on June 20 granted a disability insurer’s motion to dismiss after determining that a former professional hockey player’s claims are preempted under the Employee Retirement Income Security Act (Aaron Rome v. HCC Life Insurance Co., No. 16-2480, N.D. Texas, 2018 U.S. Dist. LEXIS 102962).

  • July 6, 2018

    9th Circuit Panel Refuses To Rehear Arguments In Disability Benefits Suit

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on July 3 denied a petition for rehearing, refusing to reconsider a June 15 remand of a disability benefits dispute to a 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 and 16-56487, 9th Cir., 2018 U.S. App. LEXIS 18228).

  • July 5, 2018

    Denial Of Disability Benefits Was Abuse Of Discretion, Federal Judge Says

    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).

  • July 5, 2018

    Judge: Insured Cannot Recover Attorney Fees In Insurance Bad Faith Dispute

    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).

  • July 2, 2018

    Federal Judge Reduces Disability Claimant’s Attorney Fee Award

    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).

  • June 29, 2018

    COMMENTARY: An Overview Of Digital Accessibility Terms And Today’s Legal Landscape: Updated

    By Vivian Cullipher

  • June 27, 2018

    Man Tells 10th Circuit Denial Of Benefits Was ‘Arbitrary And Capricious’

    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.).

  • June 25, 2018

    Disability Claimant Allowed To File Complaint; Judgment In Insurer’s Favor Vacated

    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).

  • June 22, 2018

    Disability Claimant Owed Own-Occupation Benefits; Attorney Fee Award Remanded

    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).

  • June 22, 2018

    Insurer’s Denial Of LTD Benefits Was Not Arbitrary Or Capricious, Panel Says

    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).

  • June 21, 2018

    7th Circuit Panel Says Claimant Is Not Entitled To Total Disability Benefits

    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).

  • June 21, 2018

    LTD Claim Remanded; Administrator Must Consider Effects Of Medications

    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).

  • June 19, 2018

    California Federal Judge Overturns Insurer’s Denial Of LTD Benefits

    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).

  • June 18, 2018

    Disability Benefits Suit Remanded For Determination On Equitable Remedy

    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).

  • June 14, 2018

    Disability Claimant Failed To File Suit Within Plan’s Limitations Period, Judge Says

    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).

  • June 14, 2018

    Louisiana Federal Judge Orders Disability Insurer To Supplement Responses

    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).

  • June 8, 2018

    Disability Claimants Seek High Court’s Review Of Service-Of-Suit Ruling

    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).