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Mealey's Disability Insurance

  • February 07, 2025

    Corporate Attorney Alleges Disability Insurer Failed To Conduct Full, Fair Review

    LOS ANGELES — A disability insurer failed to conduct a full and fair review of a corporate attorney’s long-term disability (LTD) benefits claim because the insurer failed to address how the attorney’s physical disabilities contributed to her inability to perform her duties as a corporate attorney, the plan participant says in a Feb. 6 complaint filed in California federal court.

  • February 07, 2025

    LTD Benefits Termination Was Not Arbitrary, Capricious, Magistrate Judge Says

    JACKSONVILLE, Fla. — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was de novo wrong; however, the termination was not arbitrary and capricious because the disability insurer had reasonable grounds to support its termination of benefits decision, a Florida federal magistrate judge said in recommending that the disability insurer’s motion for summary judgment be granted.

  • February 06, 2025

    Indiana Federal Judge Refuses To Reconsider Evidence Ruling In Disability Dispute

    FORT WAYNE, Ind. — An Indiana federal judge on Feb. 5 denied a disability insurer’s motion for reconsideration, refusing to reconsider a decision granting a disability claimant’s motion to exclude evidence collected after the date on which a long-term disability (LTD) benefits claim was deemed exhausted based on the insurer’s failure to decide the claimant’s appeal within 45 days as required by regulations set forth by the U.S. Department of Labor.

  • February 06, 2025

    Disability Plan Administrator Failed To Conduct Full, Fair Review, Panel Says

    RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals reversed a district court’s ruling in favor of a disability plan and said remand to the plan administrator is necessary because the plan administrator failed to consider evidence submitted by the disability claimant as part of his administrative appeal following the termination of his long-term disability (LTD) benefits.

  • February 06, 2025

    Federal Judge Says Denial Of Disability Benefits Was Not Arbitrary, Capricious

    NEW YORK — A disability insurer’s denial of a long-term disability (LTD) benefits claim was not arbitrary and capricious because the insurer’s denial was supported by substantial evidence and because the insurer provided the disability claimant the opportunity to respond to all evidence collected by the insurer’s medical reviewers, a New York federal judge said in granting judgment in favor of the insurer.

  • February 05, 2025

    Oral Surgeon Says Disability Benefits Owed Based On Danger Of Contracting COVID-19

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals should reverse a district court’s ruling in favor of a disability insurer because the lower court erred in failing to acknowledge that an oral surgeon’s return to work would endanger his life and health based on his risk of contracting COVID-19 and suffering complications from the virus based on comorbid conditions of asthma and hypertension, the surgeon says in his appellant reply brief.

  • January 29, 2025

    Disability Income Insurer Properly Interpreted Policy Terms, Panel Says

    BOSTON — A trial court did not err in granting a disability income insurer’s motion for judgment on the pleadings on breach of contract and bad faith claims because the policy clearly defines how monthly benefits will be paid to an insured and how monthly benefits will be paid under the disability insurance policy’s lifetime rider, a Massachusetts Appeals Court panel said in affirming the trial court’s ruling.

  • January 28, 2025

    Lower Court Did Not Commit Reversible Error In Ruling For Disability Insurers

    ATLANTA — The 11th Circuit U.S. Court of Appeals affirmed a district court’s grant of summary judgment in favor of two disability insurers, noting in a three-page unpublished opinion that the lower court did not commit reversible error in entering judgment for the insurers after determining that the doctrine of issue preclusion bars the disability claimant from arguing that he remains disabled under a group disability policy.

  • January 27, 2025

    Disability Claimant Failed To Meet Necessary Heightened Standard, Panel Says

    CINCINNATI — A district court did not err in dismissing a disability claimant’s suit because the claimant failed to meet a heightened standard that is necessary to prevail on an estoppel claim when a plan’s terms are unambiguous, the Sixth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.

  • January 24, 2025

    Any-Occupation Ruling Must Be Reversed, Disability Claimant Tells 11th Circuit

    ATLANTA — A district court’s ruling that a disability insurer’s termination of benefits after 11 years was not arbitrary and capricious must be reversed because the evidence shows that the claimant’s disability worsened and that the insurer’s handling of the medical evidence was unreasonable, a disability claimant tells the 11th Circuit U.S. Court of Appeals in her appellant brief.

  • January 22, 2025

    Judgment In Favor Of Disability Insurer Should Be Reversed, Claimant Says

    ATLANTA — A district court erred in entering judgment in favor of a disability insurer because objective medical evidence supports a finding that a disability claimant’s medical conditions and limitations prevented her from performing the material duties of any occupation, the claimant says in an appellant brief filed in the 11th Circuit U.S. Court of Appeals.

  • January 21, 2025

    Disability Claimant To 7th Circuit: Lower Court Erred In Finding Burden Not Met

    CHICAGO — A district court erred in finding that a disability claimant failed to meet her burden of proving by a preponderance of the evidence that she remained disabled from working in a sedentary occupation as a result of symptoms related to fibromyalgia because the lower court ignored relevant precedent in finding that the claimant was no longer disabled, the claimant says in an appellant brief filed in the Seventh Circuit U.S. Court of Appeals.

  • January 15, 2025

    Questions Of Fact Exist On Disability Insurer’s Initial Denial Of LTD Claim

    SAN FRANCISCO — A bad faith claim alleged against a disability insurer can proceed because questions of fact exist on the issue of whether the insurer’s initial denial of a long-term disability (LTD) benefits claim was reasonable based on the evidence available to the insurer, a California federal judge said.

  • January 10, 2025

    Disability Insurer Wrongfully Terminated Benefits, Woman With Long COVID Says

    RIVERSIDE, Calif. — A woman who was diagnosed with long COVID filed suit on Jan. 9 in California federal court against her disability insurer, alleging that the insurer wrongfully terminated her long-term disability (LTD) benefits after determining that she was able to perform the duties of her own occupation as the director of operations at a museum.

  • January 10, 2025

    Disability Claimant Says Insurer Breached Policy, Acted Arbitrarily, Capriciously

    MIAMI — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was arbitrary and capricious and constitutes a breach of the disability policy, a disability claimant alleges in a Jan. 9 complaint filed in Florida federal court.

  • January 10, 2025

    Federal Judge Says Application Of Mental Health Limitation Was Not Unreasonable

    FORT LAUDERDALE, Fla. — A Florida federal judge granted summary judgment in favor of a disability insurer after finding that the insurer did not incorrectly determine the claimant’s date of disability and did not unreasonably apply a mental health limitation to limit the payment of long-term disability (LTD) benefits to the claimant.

  • January 10, 2025

    Parties In Disability Dispute Allowed To File Administrative Record Under Seal

    SPRINGFIELD, Mass. — A Massachusetts federal magistrate judge granted a joint motion filed by a disability claimant and disability insurer to file the administrative record under seal, according to a note on the court docket.

  • January 10, 2025

    Claimant Met Burden Of Showing She Is Disabled From Own Occupation, Judge Says

    SAN FRANCISCO — A California federal judge granted a disability claimant’s motion for judgment and denied a disability insurer’s motion for judgment after determining that the disability claimant met her burden of proving that she is disabled from performing the duties of her own occupation.

  • January 10, 2025

    Magistrate Judge Says Disability Insurer Did Not Have Right To Terminate Benefits

    ORLANDO, Fla. — A Florida federal magistrate judge recommended that a disability claimant’s motion for summary judgment be granted and recommended a finding that the disability insurer’s decision to terminate the claimant’s long-term disability (LTD) benefits was arbitrary and capricious because the insurer did not have the right to terminate the claimant’s benefits based on a failure to provide additional documents.

  • January 09, 2025

    NFL Disability Plan Tells 11th Circuit District Court Ruling Must Be Affirmed

    ATLANTA — A district court’s ruling in favor of the National Football League’s disability plan must be affirmed because the former NFL player failed to exhaust all administrative remedies and failed to show that any exceptional circumstances excused the failure to exhaust all administrative remedies, the plan says in its appellee brief filed in the 11th Circuit U.S. Court of Appeals.

  • January 09, 2025

    Surgeon’s Petition For Rehearing Of Lifetime Sickness Benefits Dispute Denied

    SPRINGFIELD, Mo. — The Southern District Missouri Court of Appeals denied a disability claimant’s motion for rehearing, refusing to reconsider its ruling that a trial court properly found that a disability insurer did not breach its contract in determining that the insured surgeon was not entitled to lifetime sickness benefits because the surgeon was not totally disabled at the age of 60 prior to the policy anniversary date as required by the lifetime sickness benefits rider.

  • January 09, 2025

    Disability Insurer Cannot Use Evidence Collected After Claim Was Deemed Exhausted

    FORT WAYNE, Ind. — A disability insurer is not permitted to introduce any evidence gathered after the date on which a claimant’s long-term disability (LTD) benefits claim was deemed exhausted because the insurer failed to issue a decision of the claimant’s appeal within 45 days as required by regulations set forth by the U.S. Department of Labor, an Indiana federal judge said in granting the claimant’s motion to exclude evidence collected after the date on which the claim was deemed exhausted.

  • January 09, 2025

    Disability Insurer Identified Substantial Evidence To Support Benefits Termination

    DENVER — The 10th Circuit U.S. Court of Appeals affirmed a district court’s ruling that a disability insurer’s termination of disability benefits was reasonable because the insurer identified substantial evidence to support its finding that the claimant was not disabled from performing the duties of any occupation.

  • January 08, 2025

    Disability Claimant Failed To Meet Burden Of Proving Benefits Are Owed, Panel Says

    PASADENA, Calif. —  The Ninth Circuit U.S. Court of Appeals affirmed a district court’s ruling in favor of a disability insurer after determining that the lower court did not err in finding that the claimant failed to prove by a preponderance of the evidence that she is entitled to short-term disability (STD) and long-term disability (LTD) benefits because she failed to provide any objective findings in support of her claimed disability.

  • January 08, 2025

    Disability Insurer’s Termination Of Benefits Was Not Arbitrary, Capricious

    NEW YORK — The Second Circuit U.S. Court of Appeals affirmed a district court’s judgment in favor of a disability insurer, agreeing with the lower court’s conclusion that the insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the termination was based on substantial evidence.