Mealey's Disability Insurance

  • November 21, 2019

    Disability Administrator Abused Discretion In Denying LTD Claim, Panel Says

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on Nov. 19 remanded a long-term disability (LTD) benefits claim to the plan administrator after determining that the plan administrator abused its discretion in denying benefits based on the one-week waiting period required by the plan (Michael Alves v. Hewlett-Packard Comprehensive Welfare Benefits Plan, et al., No. 18-55819, 9th Cir., 2019 U.S. App. LEXIS 34362).

  • November 19, 2019

    Disability Insurer Considered Treating Physicians’ Opinions, Federal Judge Says

    COLUMBUS, Ohio — A disability insurer’s denial of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer considered the opinions of the claimant’s treating physicians in addition to the insurer’s independent reviewers, an Ohio federal judge said Nov. 15 in denying the claimant’s motion for judgment on the administrative record (Daniel M. Wehner v. Standard Insurance Co., No. 18-982, S.D. Ohio, 2019 U.S. Dist. LEXIS 198660).

  • November 18, 2019

    Federal Jurisdiction Does Not Exist; Disability Suit Remanded To State Court

    SAN FRANCISCO — A California federal magistrate judge on Nov. 15 remanded a disability claimant’s suit after determining that diversity of jurisdiction does not exist because a negligence claim asserted against the insurance agency that sold the disability policies to the claimant may not be time-barred under California law (Mark Bennett, D.D.S. v. Ohio National Life Assurance Corp., et al., No. 19-5774, N.D. Calif., 2019 U.S. Dist. LEXIS 198719).

  • November 15, 2019

    Termination Of LTD Benefits Supported By Substantial Evidence

    LAFAYETTE, La. — The termination of a disability plan participant’s long-term disability benefits was not arbitrary and capricious, a Louisiana federal judge said Nov. 12, because the decision to terminate benefits was supported by substantial evidence (Jerry Courville v. Life Insurance Company of North America et al., No. 18-1133, W.D. La., 2019 U.S. Dist. LEXIS 197469).

  • November 15, 2019

    Disability Claimant Files Suit Seeking Past, Future LTD Benefits Under Plan

    ALEXANDRIA, Va. — A disability claimant filed suit Nov. 13 in Virginia federal court seeking a declaration that she is entitled to past and future long-term disability (LTD) benefits under a plan issued by her employer (Amanda Taylor v. Life Insurance Company of North America, No. 19-1443, E.D. Va.).

  • November 13, 2019

    Federal Judge Says NFL Player’s Equitable Estoppel Claim Must Be Dismissed

    TAMPA, Fla. — A Florida federal judge on Nov. 12 dismissed a former National Football League player’s equitable estoppel claim in a suit seeking additional disability benefits after determining that the player failed to prove that the equitable estoppel claim falls into a limited circumstance under the Employee Retirement Income Security Act as set forth by the 11th Circuit U.S. Court of Appeals (Tyrone Keys v. Bert Bell/Pete Rozelle NFL Player Retirement Plan, et al., No. 18-2098, M.D. Fla., 2019 U.S. Dist. LEXIS 195505).

  • November 13, 2019

    Judge Dismisses Disability Plan From Suit Pursuant To Parties’ Stipulation

    SACRAMENTO, Calif. — A California federal judge on Nov. 8 dismissed a long-term disability plan from a disability claimant’s suit seeking long-term disability benefits based on a stipulation submitted to the court by the parties (Lydia Kahler v. Hartford Life & Accident Insurance Co., et al., No. 19-1913, E.D. Calif., 2019 U.S. Dist. LEXIS 195381).

  • November 08, 2019

    Pre-Existing Condition Exclusion Bars LTD Benefits For Drug Dependence

    ATLANTA — A disability insurer’s denial of a long-term disability claim for substance abuse was not arbitrary and capricious because the medical evidence supports the insurer’s finding that the pre-existing condition exclusion applied as a bar to benefits, the 11th Circuit U.S. Court of Appeals said Nov. 7 (Anthony J. Ferrizzi v. Reliance Standard Life Insurance Co., No. 18-11803, 11th Cir., 2019 U.S. App. LEXIS 33350).

  • November 07, 2019

    Disability Insurer’s Denial Of Benefits Supported By Evidence, Judge Determines

    SAN JOSE, Calif. — A disability claimant failed to prove that he was disabled from his own occupation as a result of sickness or injury according to the plan’s terms, a California federal judge said Nov. 6 after applying a de novo standard of review based on a remand order issued by the Ninth Circuit U.S. Court of Appeals (Robert Gordon v. Metropolitan Insurance Co., No. 10-5399, N.D. Calif., 2019 U.S. Dist. LEXIS 193142).

  • November 07, 2019

    Termination Of LTD Benefits Was Not Arbitrary, Capricious, Federal Judge Says

    LAFAYETTE, La. — A disability insurer’s termination of disability benefits based on its finding that the claimant was not disabled from any occupation was not arbitrary and capricious because the insurer considered the opinion of the claimant’s treating physician and the insurer based its decision on substantial medical evidence, a Louisiana federal judge said Nov. 5 (Darrell Goodman v. Reliance Standard Life Insurance Co., No. 18-623, W.D. La., 2019 U.S. Dist. LEXIS 193123).

  • November 06, 2019

    Disability Claimant’s Suit Transferred To Western District Of Louisiana

    NEW ORLEANS — A Louisiana federal judge on Oct. 31 granted a disability insurer’s motion to transfer a disability claimant’s suit seeking long-term disability (LTD) benefits to the U.S. District Court for the Western District of Louisiana after determining that the Western District has more connections to the suit than the Eastern District of Louisiana where the suit was filed (Sandra K. Racca v. The Prudential Insurance Company of America, No. 19-12120, E.D. La., 2019 U.S. Dist. LEXIS 188982).

  • November 06, 2019

    Disability Claimant Failed To Establish Amount In Controversy Exceeds $75K

    NEW ORLEANS — A Louisiana federal judge on Oct. 31 dismissed a disability claimant’s suit after determining that the claimant failed to establish that the amount in controversy exceeds the federal jurisdictional minimum of $75,000 and that the employee welfare plan is a governmental plan that is exempt from the Employee Retirement Income Security Act (Mary Beth Chauvin v. Symetra Life Insurance Co., No. 19-10493, E.D. La., 2019 U.S. Dist. LEXIS 189596).

  • November 06, 2019

    Disability Claimant Failed To Prove She Is Disabled From Performing Any Occupation

    COVINGTON, Ky, — A Kentucky federal judge on Nov. 5 denied a disability claimant’s motion for judgment on the administrative record after determining that the claimant failed to prove that she is incapable of performing any reasonable occupation as defined by the disability plan (Lisa Meiman v. Aetna Life Insurance Co., No. 18-75, E.D. Ky., 2019 U.S. Dist. LEXIS 191448).

  • November 05, 2019

    Federal Magistrate Judge Says Disability Plan Did Not Abuse Its Discretion

    SACRAMENTO, Calif. — A California federal magistrate judge on Nov. 1 recommended that judgment be entered in favor of a disability claim because the denial of a claim for an extension of short-term disability (STD) benefits was not an abuse of discretion and is supported by the medical evidence (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2019 U.S. Dist. LEXIS 190308).

  • November 04, 2019

    6th Circuit Majority Says Disability Insurer’s Benefits Denial Was Not Reasonable

    CINCINNATI — The majority of a Sixth Circuit U.S. Court of Appeals panel on Oct. 31 vacated a district court’s judgment in favor of a disability insurer after determining that the insurer’s denial of disability benefits was arbitrary and capricious because the insurer’s decision was not the result of a deliberate, principled reasoning process regarding the claimant’s ability to perform her job as a nurse (Susan Card v. Principal Life Insurance Co., No. 18-6095, 6th Cir., 2019 U.S. App. LEXIS 32573).

  • October 30, 2019

    Disability Claimant’s Suit Dismissed With Prejudice Per Parties’ Request

    LAS VEGAS — Following the Ninth Circuit U.S. Court of Appeals’ decision to remand a disability claimant’s suit to consider the source of the claimant’s disability, a Nevada federal judge on Oct. 29 granted the parties’ stipulation for dismissal of the suit with prejudice (Miae Decovich v. Venetian Casino Resort LLC, et al., No. 11-872, D. Nev.).

  • October 30, 2019

    Disability Claimant Entitled To STD Benefits, Wisconsin Federal Judge Determines

    MADISON, Wis. — A Wisconsin federal judge on Oct. 29 awarded a disability claimant short-term disability (STD) benefits after determining that a disability insurer failed to consider all of the job duties required of the claimant, rather than the modified job duties performed by the claimant, when it denied her claim for benefits (Catherine A. Mathews v. The Northwestern Mutual Life Insurance Co., No. 18-46, W.D. Wisc., 2019 U.S. Dist. LEXIS 186986).

  • October 30, 2019

    Disability Plan’s Forum- Selection Clause Valid, North Carolina Federal Judge Says

    RALEIGH, N.C. — A forum-selection clause in a short-term disability policy is valid and enforceable, a North Carolina federal judge said Oct. 28 in granting a disability plan’s motion to transfer venue of a disability claimant’s suit to Wisconsin federal court (Kydra Manuel-Clark v. ManpowerGroup Short-Term Disability Plan, No. 19-147, E.D. N.C., 2019 U.S. Dist. LEXIS 185805).

  • October 22, 2019

    Negligence, Misrepresentation Claims To Proceed In Disability Benefits Dispute

    KANSAS CITY, Mo. — A disability claimant’s negligence and misrepresentation allegations against an insurance broker can proceed because the broker owes an independent duty to the disability claimant, a Kansas federal judge said in refusing to dismiss the misrepresentation and negligence claims (Robert P. Garver v. Principal Life Insurance Co. et al., No. 19-2354, D.  Kan., 2019 U.S. Dist. LEXIS 180603).

  • October 21, 2019

    Judgment Properly Entered For Disability Insurer, 9th Circuit Panel Says

    SAN DIEGO — A district court did not err in entering judgment in favor of a disability insurer because the disability claimant failed to prove that she was unable to perform the duties of her own occupation while she was still employed by her former employer and because the district court properly considered all of the claimant’s evidence, the Ninth Circuit U.S. Court of Appeals said Oct. 18 (Kelly Demko v. Unum Life Insurance Company of America, No. 18-55428, 9th Cir., 2019 U.S. App. LEXIS 31102).