Mealey's Disability Insurance

  • 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).

  • January 15, 2020

    Bad Faith Claim Against Disability Income Insurer To Proceed, Judge Says

    SCRANTON, Pa. — A Pennsylvania federal judge on Jan. 13 denied a disability income insurer’s motion for partial summary judgment on a bad faith claim because the insured provided sufficient evidence from which a jury could find that the insurer acted in bad faith in denying the claim for disability income benefits (Joseph D. Dileo v. Federated Life Insurance Co., No. 18-628, M.D. Pa., 2020 U.S. Dist. LEXIS 5003).

  • January 14, 2020

    Pre-Existing Condition Exclusion Does Not Bar LTD Benefits, Judge Determines

    NEW ORLEANS — A disability insurer wrongfully denied a claim for long-term disability (LTD) benefits based on the plan’s pre-existing condition exclusion because the back injury the claimant sustained while working was not caused by the claimant’s pre-existing degenerative back condition, a Louisiana federal judge said Jan. 13 in awarding the claimant past and future LTD benefits (Karl Meche v, Metropolitan Life Insurance Co., No. 18-3995, E.D. La., 2020 U.S. Dist. LEXIS 5200).

  • January 13, 2020

    Disability Insurer’s Calculation Of Benefits Was Reasonable

    CENTRAL ISLIP, N.Y. — A New York federal magistrate judge on Jan. 8 recommended granting a disability insurer’s motion for summary judgment after determining that the insurer’s calculation of monthly disability benefits was not unreasonable (Jason Brand v. Narco Freedom Inc., et al., No. 15-5021, E.D. N.Y., 2020 U.S. Dist. LEXIS 3813).

  • January 13, 2020

    Disability Claimant’s Motion To Remand Denied; Federal Jurisdiction Is Proper

    LOUISVILLE, Ky. — A disability claimant’s allegations against Kentucky’s insurance commissioner and the Kentucky Department of Insurance (DOI) must be dismissed, a Kentucky federal judge said Jan.  9 after determining that the claimant failed to exhaust all administrative remedies with the commissioner and the DOI (Charles A. Knoppe v. Lincoln National Life Insurance Co., et al., No. 18-264, W.D. Ky., 2020 U.S. Dist. LEXIS 3612).

  • January 09, 2020

    Panel Says Opinions Of Disability Claimant’s Treating Physicians Must Be Considered

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Jan. 7 vacated and remanded a disability claimant’s suit seeking long-term disability benefits after determining that a district court erred in failing to consider letters from the claimant’s treating physicians who were not provided with the opportunity to rebut the opinion of one of the insurer’s examining physicians (Lea Wagenstein v. Cigna Life Insurance Co., et al., No. 18-55955, 9th Cir., 2020 U.S. App. LEXIS 482).

  • January 08, 2020

    Orthopedic Surgeon Not Entitled To Total Disability Benefits, Judge Determines

    NEW YORK — A New York federal judge on Jan. 3 granted a disability insurer’s motion for summary judgment and denied a disability claimant’s motion for summary judgment after determining that an orthopedic surgeon is not entitled to total disability benefits for the periods in which he returned to work because he was still able to complete the majority of his responsibilities as an orthopedic surgeon even though he was unable to perform surgeries (Richard Sternberg v. Paul Revere Life Insurance Co., No. 17-8523, S.D. N.Y., 2020 U.S. Dist. LEXIS 1718).

  • January 07, 2020

    Former NFL Player’s Suit Seeking Additional Disability Benefits Dismissed

    SAN JOSE, Calif. — A California federal judge on Jan. 3 dismissed a former National Football League (NFL) player’s complaint seeking additional disability benefits because the complaint fails to state a claim upon which relief can be granted and because the issue of the denial of benefits was litigated in a previous suit filed by the former player (Delvin Williams v. The NFL Player Supplemental Disability Plan et al., No. 19-4236, N.D. Calif., 2020 U.S. Dist. LEXIS 1551).

  • January 06, 2020

    Disability Claimant Cannot Collect Consequential Damages, Judge Says

    MINNEAPOLIS — A Minnesota federal judge on Jan. 3 granted a disability insurer’s motion for partial summary judgment after determining that a disability claimant failed to prove that the insurer’s termination of disability benefits caused the claimant to sustain consequential damages in the form of lost employer-provided health and life insurance (Matthew J. Christoff v. Paul Revere Life Insurance Co., No. 17-3515, D. Minn., 2020 U.S. Dist. LEXIS 808).

  • January 06, 2020

    Bad Faith Claim Cannot Proceed Without Breach Of Contract, Federal Judge Says

    LOUISVILLE, Ky. — A Kentucky federal judge on Dec. 31 granted a disability insurer’s motion for summary judgment on a claimant’s bad faith claim after determining that the bad faith claim cannot proceed without the breach of contract claim, which was dismissed in a prior ruling by the court (James H. Pogue v. Principal Life Insurance Co., No. 14-599, W.D. Ky., 2019 U.S. Dist. LEXIS 222947).

  • January 02, 2020

    8th Circuit Affirms Finding That Denial Of STD Claim Was Not Unreasonable

    ST. LOUIS — The Eighth Circuit U.S. Court of Appeals on Dec. 23 affirmed a district court’s ruling that the denial of a claim for short-term disability (STD) benefits was not unreasonable after determining that the claimant failed to present a valid basis for reversal (Jacqueline E. Presi v. Ascension Health Alliance, doing business as Ascension, et al., No. 19-1792, 8th Cir., 2019 U.S. App. LEXIS 38198).

  • December 19, 2019

    Disability Claimant Met Plan Requirements To Qualify For Benefits

    ANN ARBOR, Mich. — A disability claimant is entitled to short-term disability and long-term disability benefits because the claimant proved by a preponderance of the evidence that she met all four conditions listed in the disability plan to qualify for benefits, a Michigan federal judge said Dec. 17 (Brenda Counts v. United of Omaha Life Insurance Co., No. 18-12312, E.D. Mich., 2019 U.S. Dist. LEXIS 216274).

  • December 18, 2019

    Claimant Failed To Prove Disability Prevented Him From Working, Judge Says

    TACOMA, Wash. — A disability insurer did not wrongfully deny a claim for short-term disability benefits because the disability claimant failed to prove that he was disabled from performing the duties of his own occupation prior to his termination, a Washington federal judge said Dec. 16 (James M. Kollar v. Sun Life Assurance Company of Canada, No. 19-5180, W.D.  Wash., 2019 U.S. Dist. LEXIS 215947).

  • December 17, 2019

    Insurer’s Termination Of Disability Benefits Based On Substantial Evidence

    ST. LOUIS — A district court properly entered judgment for a disability insurer because the insurer did not wrongfully terminate a claimant’s long-term disability benefits based on its determination that the claimant's mental illness was not caused by a physical disability, the Eighth Circuit U.S. Court of Appeals said Dec. 16 (Diane Miller v. Hartford Life and Accident Insurance Co., No. 19-1096, 8th Cir., 2019 U.S. App. LEXIS 37168).

  • December 17, 2019

    Some Supplementary Responses Are Appropriate In Disability Suit, Judge Says

    LEXINGTON, Ky. — A Kentucky federal judge on Dec. 13 partially granted a disability claimant’s motion to compel supplementary responses regarding information related to the supervision of the claimant’s disability benefits investigation but denied the claimant’s motion to  compel the deposition of a claims analyst because the claimant failed to meet the court’s scheduling deadline for deposition requests (Jennifer Lee Smith v. Hartford Life & Accident Insurance Co., No. 19-61, E.D. Ky., 2019 U.S. Dist. LEXIS 215084).

  • December 16, 2019

    Disability Claimant Not Permitted To Conduct Extra-Record Discovery, Judge Says

    OKLAHOMA CITY — An Oklahoma federal judge on Dec. 6 denied a disability claimant’s motion to conduct discovery outside of the administrative record after determining that the claimant failed to carry his burden of proving that the disability insurer’s conflict of interest as both claims administrator and claims payer warrants the requested discovery (John Williamson v. Unum Life Insurance Company of America, No. 19-481, W.D. Okla., 2019 U.S. Dist. LEXIS 210631).

  • December 16, 2019

    Disability Insurers Did Not Breach Contract; Mental Limitation Properly Applied

    NEW ORLEANS — A Louisiana federal judge on Dec. 13 dismissed a disability claimant’s complaint after determining that the disability insurers did not breach their insurance policies by limiting the claimant’s benefits to 24 months under the policies’ 24-month limitation provision for mental disorders (Allan Cougle v. Berkshire Life Insurance Company of America, et al., No. 19-9257, E.D. La., 2019 U.S. Dist. LEXIS 215019).

  • December 16, 2019

    District Court Correctly Found Disability Claimant Is Not Entitled To Benefits

    NEW YORK — A disability claimant is not entitled to benefits under his former employer’s disability plan because the claimant failed to show that he sustained a 20 percent or more reduction in income as a result of a disability or that there was a causal connection between his disability and the termination of his employment, the Second Circuit U.S. Court of Appeals affirmed Dec. 13 (Joseph Sevely v. The Bank of New York Mellon Corporation Long Term Disability Plan, et al., No. 18-3247, 2nd Cir., 2019 U.S. App. LEXIS 36854).

  • December 12, 2019

    Disability Insurer Incorrectly Calculated First Day Of Disability, Judge Concludes

    CHICAGO — An Illinois federal judge on Dec. 10 granted a disability claimant’s motion for summary judgment after determining that the disability insurer incorrectly calculated the claimant’s first day of disability and the salary on which his long-term disability (LTD) benefits should be based (Harlan Ten Pas v. The Lincoln National Life Insurance Co., No. 18-3694, N.D. Ill., 2019 U.S. Dist. LEXIS 212284).

  • December 12, 2019

    Disability Plan’s Appeal Dismissed; Order Was Not Appealable, Panel Says

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on Dec. 11 dismissed a disability plan’s appeal for lack of jurisdiction after determining that the district court’s ruling was not a final decision because the merits of the disability claim have yet to be resolved (Sherry Laake v. Benefits Committee, Western & Southern Financial Group Company Flexible Benefits Plan, et al., No. 19-3233, 6th Cir., 2019 U.S. App. LEXIS 36634).