Mealey's Disability Insurance

  • October 22, 2020

    Disability Claimant Failed To Exhaust Administrative Remedies, Panel Says

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Oct. 21 affirmed a district court’s ruling that a disability claimant’s suit must be dismissed for failure to exhaust all administrative remedies because the claimant clearly failed to timely file an administrative appeal of the insurer’s termination of her long-term disability (LTD) benefits claim (Patricia D. White v. Anthem Life Insurance Co., No. 19-16954, 9th Cir., 2020 U.S. App. LEXIS 33213).

  • October 20, 2020

    Disability Claimant Awarded Attorney Fees; Judgment Stayed To Allow Insurer’s Appeal

    DALLAS — A Texas federal judge on Oct. 19 awarded a disability claimant more than $84,000 in attorney fees after determining that the award is warranted based on the claimant’s success on the merits; however, the judge allowed the insurer to post a bond and stayed the execution of the judgment to permit the insurer to file an appeal (Jose Chavez v. Standard Insurance Co., No. 18-2013, N.D. Texas, 2020 U.S. Dist. LEXIS 192877).

  • October 19, 2020

    Federal Judge Grants Stipulation To File Disability Record Under Seal

    TACOMA, Wash. — A Washington federal judge on Oct. 16 granted a joint stipulation to file the administrative record in a disability dispute under seal, agreeing with the parties that the need to protect the disability claimant’s privacy is a compelling reason to file the record under seal (Randolff Scott Ruffell Westover v. Life Insurance Company of North America, No. 20-5606, W.D. Wash., 2020 U.S. Dist. LEXIS 192304).

  • October 16, 2020

    Disability Claimant’s LTD Claim Remanded To Plan Administrator

    PHOENIX — An Arizona federal judge on Oct. 13 granted a disability claimant’s motion to supplement the administrative record and to remand to the plan administrator for reconsideration of its termination of long-term disability benefits after determining that the claimant would have submitted the information had she known that she could do so as part of the administrative appeal process (Ramina Johal v. United States Life Insurance Company in the City of New York, No. 20-204, D. Ariz., 2020 U.S. Dist. LEXIS 190796).

  • October 16, 2020

    Bad Faith Claim To Proceed Against Disability Insurer, Oklahoma Federal Judge Says

    TULSA, Okla. — An Oklahoma federal judge on Oct. 15 determined that a bad faith claim will proceed in a disability benefits dispute because genuine issues of material fact exist on the reasonableness of the disability insurer’s actions in its investigation of the claim (Jody Fees v. American Family Life Insurance Company of Columbus [Aflac], No. 19-476, N.D. Okla., 2020 U.S. Dist. LEXIS 190797).

  • October 16, 2020

    Panel Says Plan Abused Its Discretion In Calculating NFL Player’s Disability Award

    ATLANTA — The 11th Circuit U.S. Court of Appeals on Oct. 15 determined that a district court erred in granting a disability plan’s motion for judgment on the administrative record because the plan abused its discretion in failing to consider relevant evidence and in failing to consider the cumulative effects of the former National Football League (NFL) player’s ailments (Darren Mickell v. Bert Bell/Pete Rozelle NFL Players Retirement Plan, No. 19-10651, 11th Cir., 2020 U.S. App. LEXIS 32516).

  • October 08, 2020

    Disability Claimant Is Not Entitled To Attorney Fees, Federal Judge Says

    PHOENIX — An Arizona federal judge on Sept. 4 denied a disability claimant’s motion for attorney fees after determining that the claimant failed to prove that the remand of his claim for long-term disability benefits warrants an award of attorney fees (Michael Woolsey v. Aetna Life Insurance Co., et al., No. 18-578, D. Ariz., 2020 U.S. Dist. LEXIS 182455).

  • October 07, 2020

    Disability Pension Plan Should Have Considered Social Security Award, Judge Says

    CAPE GIRARDEAU, Mo. — A Missouri federal judge on Oct. 6 denied a disability pension plan’s motion to dismiss after determining that the plan should have considered the claimant’s evidence of a favorable Social Security Administration disability award even if the claimant submitted the award beyond the plan’s 180-day period for making an initial determination (Adam Ruessler v. Boilermakers-Blacksmiths National Pension Trust Board of Trustees, No. 20-128, E.D. Mo., 2020 U.S. Dist. LEXIS 184681).

  • October 06, 2020

    Disability Insurer's Termination Of LTD Benefits Was Not Arbitrary, Capricious

    CHATTANOOGA, Tenn. — A disability insurer's termination of long-term disability benefits was not arbitrary and capricious because the insurer reasonably interpreted its policy and provided reasoned explanations for its decision to terminate the claimant's benefits, a Tennessee federal judge said Oct. 2 (Boyd Lewis v. Unum Life Insurance Company of America, No. 18-127, E.D. Tenn., 2020 U.S. Dist. LEXIS 183165).

  • October 01, 2020

    Disability Claimant Failed To Exhaust All Administrative Remedies Before Filing Suit

    MONTGOMERY, Ala. — An Alabama federal judge on Sept. 30 dismissed a disability claimant's suit with prejudice after determining that the claimant failed to exhaust all administrative remedies under the disability plan and failed to prove that exhaustion of the administrative remedies would be futile (Daniel Castleberry v. The Lincoln National Life Insurance Co., No. 19-1025, M.D. Ala., 2020 U.S. Dist. LEXIS 180498).

  • September 30, 2020

    Interpretation Of NFL Disability Plan Was Not Unreasonable, Judge Says

    HOUSTON — The denial of line of duty (LOD) disability benefits to a former National Football League player was not an abuse of discretion because the appeals committee's interpretation of the plan was not unreasonable, a Texas federal judge said Aug. 17 (Ashton Youboty v. NFL Player Disability & Neurocognitive Benefit Plan, No. 19-2306, S.D. Texas, 2020 U.S. Dist. LEXIS 173891).

  • September 29, 2020

    Conservator Timely Filed Suit Within Disability Plan's Limitations Provision

    SANTA ANA, Calif. — A California federal judge on Sept. 21 denied a disability insurer's motion to dismiss a conservator's claims for benefits and equitable relief under the Employee Retirement Income Security Act because tolling of the disability plan's three-year limitations provision did not begin until the conservator of the disability plan participant was appointed (Joyce Poisson v. Aetna Life Insurance Co., No. 20-1030, C.D. Calif., 2020 U.S. Dist. LEXIS 177216).

  • September 25, 2020

    Denial Of LTD Benefits Supported By Substantial Evidence, Magistrate Judge Says

    SALT LAKE CITY — A disability insurer did not abuse its discretion in denying a claim for long-term disability (LTD) benefits because substantial evidence supports the disability insurer's decision, a Utah federal magistrate judge said Sept. 23 (Jennifer L. v. United of Omaha Life Insurance Co., No. 18-848, D. Utah, 2020 U.S. Dist. LEXIS 175702).

  • September 25, 2020

    Federal Magistrate Denies Motion To Quash Subpoenas In Disability Dispute

    TUCSON, Ariz. — An Arizona federal magistrate judge on Sept. 23 denied a disability insurer's motion to quash four subpoenas related to the insurer's independent physician's employment history after determining that the disability claimant has shown good cause for the delay in issuing the subpoenas after the close of discovery (Herbert Jalowsky M.D. v. Provident Life and Accident Insurance Co., et al., No. 18-279, D. Ariz., 2020 U.S. Dist. LEXIS 174920).

  • September 25, 2020

    Disability Claimant's Benefits Were Properly Offset, Federal Judge Says

    SACRAMENTO, Calif. — A disability insurer properly offset a claimant's long-term disability (LTD) benefits based on settlement proceeds awarded to the claimant, a California federal judge said Sept. 22, noting that the disability plan at issue clearly permits the offset (Fadi G. Haddad v. SMG Long Term Disability Plan, et al., No. 16-1700, E.D. Calif., 2020 U.S. Dist. LEXIS 173981).

  • September 21, 2020

    Issue Of Fact Exists As To Whether Disability Policy Is Governed By ERISA

    NEW ORLEANS — A Louisiana federal judge on Sept. 16 denied a disability claimant's motion for summary judgment on the issue of whether his disability policy is governed by the Employee Retirement Income Security Act after determining that an issue of fact exists as to whether the disability policy is an individual policy or a policy included as part of an employee welfare benefit plan (Scott W. McQuaig v. Provident Life and Accident Insurance Co., No. 20-23, E.D. La., 2020 U.S. Dist. LEXIS 169391).

  • September 18, 2020

    Disability Insurer Properly Terminated LTD Benefits, Federal Judge Says

    HARRISON, Ark. — An Arkansas federal judge on Sept. 15 adopted a magistrate judge's report and recommendation and affirmed a disability insurer's termination of benefits after determining that the disability claimant failed to prove that she continued to be disabled from performing the duties of her former occupation as an account executive (Gena Leanne Whillock v. United of Omaha Life Insurance Co. et al., No. 18-3089, W.D. Ark., 2020 U.S. Dist. LEXIS 169862).

  • September 16, 2020

    NFL Player's Disability Claim Remanded For Full And Fair Review

    SAN FRANCISCO — A California federal magistrate judge on Sept. 15 remanded a former National Football League player's disability claim to the plan administrator after determining that the plan abused its discretion and did not provide the NFL player with a full and fair review as required (Charles Dimry v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, et al., No. 19-5360, N.D. Calif., 2020 U.S. Dist. LEXIS 168952).

  • September 15, 2020

    LTD Benefits Owed To Claimant Who Suffered From Lyme Disease

    RIVERSIDE, Calif. — A disability claimant met her burden of establishing that she was totally disabled from performing the duties of her occupation as a teacher as a result of complications from Lyme disease, a California federal judge said Sept. 11 in entering judgment for the claimant (Tisha Entz v. Standard Insurance Co., No. 19-402, C.D. Calif., 2020 U.S. Dist. LEXIS 166814).

  • September 14, 2020

    No Abuse Of Discretion In Terminating LTD Benefits, Idaho Federal Judge Says

    BOISE, Idaho — A disability insurer did not abuse its discretion in terminating a claimant's long-term disability benefits because the insurer reasonably relied on the medical opinions of two independent physicians in reaching its decision, an Idaho federal judge said Sept. 9 in granting the disability insurer's motion for summary judgment (Steve Wilstead v. United Heritage Life Insurance Co., No. 19-276, D. Idaho, 2020 U.S. Dist. LEXIS 166310).