Mealey's Disability Insurance
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January 25, 2023
Disability Insurer Failed To Provide Full, Fair Review, 7th Circuit Says
CHICAGO — A disability insurer failed to provide a disability claimant with a full and fair review as required by the Employee Retirement Income Security Act because the insurer did not provide the claimant with a copy of a report completed by a consulting physician prior to reaching a final determination on the claim as required by the U.S. Department of Labor’s regulations on claims procedures, the Seventh Circuit U.S. Court of Appeals said.
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January 13, 2023
Medical Doctor Is Not Entitled To Partial Disability Benefits, Judge Says
INDIANAPOLIS — A medical doctor is not entitled to partial disability benefits based on his inability to use electronic transcription software to dictate notes for medical records because the doctor is able to carry out the principal duties of his occupation without the use of the software, an Indiana federal judge said Jan. 12 in granting the insurer’s motion for summary judgment.
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January 13, 2023
Jury Verdict Against Disability Insurer To Stand, 5th Circuit Panel Says
NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals refused to reverse a jury verdict entered in favor of an insured and against a disability insurer because the district court did not abuse its discretion in denying the insurer’s motion for leave to amend its answer to add counterclaims or in excluding the insurer’s proposed expert testimony prior to trial over the insured’s breach of contract claim.
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January 13, 2023
Termination Of LTD Benefits Was Not Wrong, Arkansas Federal Judge Determines
EL DORADO, Ark. — An Arkansas federal judge found that a disability insurer did not wrongfully terminate a claimant’s long-term disability (LTD) benefits because the claimant failed to provide the insurer with the required medical evidence to support her claim for total disability.
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January 13, 2023
Termination Of LTD Benefits Was Abuse Of Discretion, Judge Says
MINNEAPOLIS — A disability insurer’s termination of a claimant’s disability benefits was an abuse of discretion because the insurer gave more credit to the opinion of its own physician than to the claimant’s treating physicians without providing a reasonable explanation for doing so, a Minnesota federal judge said in granting the claimant’s motion for summary judgment and in denying the insurer’s motion for summary judgment.
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January 12, 2023
Disability Claimant Permitted To Depose Physician, Employee, Magistrate Judge Says
SALT LAKE CITY — Additional discovery in a disability benefits dispute is warranted based on exceptional circumstances in the handling of a claim for long-term disability benefits (LTD), a Utah federal magistrate judge said in allowing the disability claimant to depose the disability insurer’s physician and one of the insurer’s employees.
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January 12, 2023
Disability Benefits Suit Transferred From Kentucky To Pennsylvania Federal Court
LOUISVILLE, Ky. — A disability claimant’s suit alleging that an insurer breached its contract in terminating her claim for long-term disability benefits must be transferred to Pennsylvania federal court because Pennsylvania is the more convenient forum for the parties, a Kentucky federal judge said in granting the insurer’s motion to transfer venue.
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January 12, 2023
Disability Claimant Permitted To Depose Physician Employed By Disability Insurer
CHICAGO — An Illinois federal magistrate judge granted a disability claimant’s motion for limited discovery and said the claimant is permitted to depose a physician employed by the disability insurer because the claimant raised the possibility that the physician operated under a conflict of interest.
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January 11, 2023
4th Circuit Dismisses Disability Claimant’s Appeal Based On Parties’ Agreement
RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeal dismissed a disability claimant’s appeal of a district court’s ruling in favor of a disability insurer after the claimant notified the appeals court that the parties reached an agreement over the termination of her long-term disability (LTD) benefits claim.
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January 11, 2023
Disability Claimant Entitled To LTD Benefits, But Bad Faith Claim Fails, Judge Says
SEATTLE — A disability claimant met his burden of proving by a preponderance of the evidence that he is disabled from performing the duties of his own occupation as a trial lawyer; however, the claimant failed to show that the disability insurer acted in bad faith in denying his claim for long-term disability (LTD) benefits, a Washington federal judge said.
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January 05, 2023
9th Circuit Panel Upholds Denial Of Attorney Fees In ERISA Disability Benefits Row
SAN FRANCISCO — Upholding denial of a disability claimant’s motion for attorney fees without deciding whether a catalyst theory of recovery applies in Employee Retirement Income Security Act cases, a Ninth Circuit U.S. Court of Appeals panel said in an unpublished memorandum disposition that there was no abuse of discretion in denying the fees based on the factors outlined in Hummell v. S. E. Rykoff & Co.
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December 28, 2022
4th Circuit: Bench Trial Was Proper In ERISA Disability Benefits Denial Case
RICHMOND, Va. — A bench trial based on the administrative record was appropriate in an Employee Retirement Income Security Act suit over denial of long-term disability benefits that featured disputed issues of material fact, a Fourth Circuit U.S. Court of Appeals panel said, affirming the trial court’s ruling against an insurer.
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December 08, 2022
Motion To Remand Disability Suit Denied; Diversity Of Citizenship Exists, Judge Says
LOS ANGELES — A California federal judge denied a disability claimant’s motion to remand a breach of contract and bad faith suit after determining that complete diversity of citizenship exists between the parties because the claimant fraudulently joined an individual who conducted surveillance video on behalf of the disability insurer in an attempt to avoid federal jurisdiction.
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December 08, 2022
Disability Insurer’s Decision To Terminate Benefits Not Arbitrary, Capricious
WICHITA, Kan. — A disability insurer’s termination of benefits based on its plan’s two-year limitation for mental health disorders was not arbitrary and capricious because the insurer’s decision was reasonable and based on substantial evidence, a Kansas federal judge said.
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December 08, 2022
Disability Insurer Seeks To Stay Suit To Allow Appeal Of Class Certification Order
WILLIAMSPORT, Pa. — A disability insurer filed a motion to stay proceedings in a suit pending in Pennsylvania federal court arising out of the insurer’s right to reimbursement from a claimant who recovered damages from a tortfeasor in an auto accident to allow the insurer to file an appeal in the Third Circuit U.S. Court of Appeal of a federal judge’s class certification order.
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December 07, 2022
Doctor Says LTD Benefits Owed For Inability To Work Based On COVID-19 Risks
ATLANTA — A disability insurer arbitrarily and capriciously denied a doctor’s claim for long-term disability (LTD) benefits because substantial evidence supports a finding that the doctor, who suffered from a number of medical conditions, was unable to work as a physician based on his high risk of contracting COVID-19 and experiencing severe complications from the virus based on his medical diagnoses, the doctor says in a complaint filed in Georgia federal court.
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December 07, 2022
Claimant Met Burden Of Showing She Is Disabled From Sedentary Occupation
LOS ANGELES — A disability claimant is entitled to long-term disability (LTD) benefits, a California federal judge said after determining that the claimant showed by a preponderance of the evidence that she is more than likely disabled from performing the duties of a sedentary occupation.
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December 07, 2022
Disability Insurer Entitled To Costs For Deposition Transcripts, Judge Says
LOUISVILLE, Ky. — A Kentucky federal judge awarded a disability insurer approximately $1,644 in costs for deposition transcripts costs after determining that the award of costs is appropriate and that the disability claimant failed to demonstrate that an award of costs is unreasonable or unnecessary.
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December 07, 2022
Suit Limitation Provision Bars Disability, Bad Faith Suit, 3rd Circuit Panel Says
PHILADELPHIA — A district court correctly concluded that an insured’s breach of contract and bad faith suit against a disability insurer is barred by the policy’s three-year suit limitation provision because the insured failed to file the suit within three years after the expiration of the 90-day appeal period following the termination of her disability benefits, the Third Circuit U.S. Court of Appeals said Dec. 6.
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December 06, 2022
Disability Insurer’s Termination Of Benefits Was Reasonable Based On Evidence
MADISON, Wis. — A Wisconsin federal judge determined that a disability insurer’s termination of long-term disability (LTD) benefits based on its finding that the claimant was no longer disabled from performing the duties of her own occupation was reasonable based on the medical evidence and the claimant’s failure to provide objective medical evidence in support of her functional limitations.
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December 05, 2022
Illinois Law Applies To Breach Of Contract, Bad Faith Claims In Disability Suit
LOS ANGELES — A California judge determined that Illinois law must be applied to breach of contract and bad faith claims in a suit filed against a disability income insurer because the policy was issued in Illinois, includes a choice-of-law provision designating Illinois law as the applicable law and does not contravene any fundamental policy of California.
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November 29, 2022
Disability Claimant’s Attorneys Awarded More Than $48,000 In Fees
WORCESTER, Mass. — A Massachusetts federal judge on Nov. 28 partially granted a disability claimant’s motion for attorney fees and costs, awarding the claimant’s attorneys more than $48,000 after finding that a reduction in the number of hours logged and a reduction in the hourly rates charged by the attorney were necessary.
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November 29, 2022
9th Circuit Dismisses Disability Insurer’s Appeal Pursuant To Stipulation
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals dismissed a disability insurer’s appeal of a district court’s judgment entered in favor of a disability claimant following the disability insurer’s filing of a stipulation to dismiss the appeal with prejudice.
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November 23, 2022
District Court Improperly Engaged In New Determination Of Claimant’s Disability
PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals determined that a district court’s finding that a disability insurer correctly denied a claim for long-term disability (LTD) benefits must be reversed because the court improperly engaged in a new determination regarding the claimant’s disability rather than simply examining the insurer’s rationale for denying the benefits claim.
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November 21, 2022
Disability Insurer Breached Contract, Acted In Bad Faith, Insured Says In Complaint
SEATTLE — A disability insurer breached its contract and acted in bad faith by failing to properly calculate the amount of residual disability benefits available under two long-term disability policies, an insured maintains in a complaint filed in Washington federal court.