Mealey's Disability Insurance : Mealey's : Legal News & Analysis

Mealey's Disability Insurance

November 10, 2022
Disability Insurer Not Entitled To Award Of Attorney Fees, Judge Says

NEW YORK — Despite a long-term disability insurer’s success on the merits, a New York federal judge denied the insurer’s motion for attorney fees because there is no evidence of bad faith or culpability on the part of the claimant and an award of attorney fees in favor of the insurer would likely deter plan participants from filing valid claims in disability disputes.
November 09, 2022
Suit Seeks Recalculation Of Disability Benefits, Is Time-Barred, Judge Says

NEW YORK — A disability claimant’s suit seeking a recalculation of residual disability benefits is time-barred because the claimant failed to file suit within three years as required by the disability policies at issue, a New York federal judge said.
November 07, 2022
Bad Faith Claim Against Disability Insurer To Proceed Under California Law

SAN DIEGO — A bad faith claim against a disability insurer will proceed because applying Illinois law would be contrary to California’s fundamental policy of providing a remedy for insurance bad faith, a California federal judge said in denying the insurer’s motion to dismiss the bad faith claim.
November 07, 2022
Disability Insurer Properly Relied On Surveillance Videos, 10th Circuit Panel Says

DENVER — A disability insurer properly relied on surveillance videos in determining that a claimant was no longer disabled from performing the duties of any occupation, the 10th Circuit U.S. Court of Appeals said in affirming a district court’s judgment in favor of the insurer.
October 26, 2022
Disability Insurer’s Benefits Termination Supported By Substantial Evidence

BLUEFIELD, W.Va. — A disability insurer’s termination of long-term disability benefits after 14 years of paying benefits was not unreasonable, a West Virginia federal judge said in finding that substantial evidence supported the insurer’s determination that the claimant was capable of working in a sedentary occupation.
October 18, 2022
Disability Claimant Appeals Judgment Entered In Disability Insurer’s Favor

MIAMI — A disability claimant filed a notice of appeal to the 11th Circuit U.S. Court of Appeals after a Florida federal judge determined that the claimant failed to show by a preponderance of the evidence that he remained disabled under the terms of the disability plan at issue.
October 11, 2022
Substantial Evidence Supports Finding That Claimant Not Disabled From Any Occupation

CINCINNATI — A disability plan’s denial of long-term disability benefits was not arbitrary and capricious because substantial evidence supported the plan’s determination that the claimant was not disabled from performing the duties of any occupation, the Sixth Circuit U.S. Court of Appeals said in affirming a district court’s opinion.
October 06, 2022
Judge: Overwhelming Medical Evidence Supports Finding That Claimant Is Disabled

SANTA ANA, Calif. — A disability insurer abused its discretion in denying a claim for long-term disability (LTD) benefits because the medical evidence overwhelmingly supports a finding that the claimant is unable to perform the duties of her own occupation, a California federal judge said in granting judgment in favor of the disability claimant.
October 06, 2022
Termination Of Disability Benefits Not Abuse Of Discretion, Judge Says

PITTSBURGH — A disability plan’s termination of a claimant’s long-term disability (LTD) benefits was not an abuse of discretion because the plan’s finding that the claimant was not disabled from performing the duties of any occupation is supported by substantial medical evidence.
October 05, 2022
Disability Claimant Entitled To Benefits For Post-Traumatic Stress Disorder

SEATTLE — A disability claimant who suffered from symptoms of post-traumatic stress disorder (PTSD) after being sexually harassed by an executive at the bank where she worked was disabled from performing the duties of her own occupation as a bank manager because the medical evidence shows that the claimant was consistently disabled from working even after she stopped working as a bank manager, a Washington federal judge said.
October 05, 2022
Breach Of Fiduciary Duty Claim Dismissed; Disability Claimant Has Adequate Remedy

ATLANTA — A Georgia federal judge granted a disability insurer’s motion to dismiss a breach of fiduciary duty claim after determining that the claimant has an adequate remedy under the law through her claim seeking a declaration that benefits are owed under the Employee Retirement Income Security Act.
October 04, 2022
Termination Of STD Benefits Not Arbitrary, Capricious, 6th Circuit Panel Says

CINCINNATI — A district court did not err in finding that the termination of short-term disability (STD) benefits was not arbitrary and capricious based on the medical evidence included in the administrative record, the Sixth Circuit U.S. Court of Appeals said in affirming the decision entered in favor of the STD plan.
October 03, 2022
High Court Denies Claimant’s Petition, Refuses To Review Disability Benefits Suit

WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 3 denied a disability claimant’s petition for writ of certiorari in a suit alleging that a settlement between the claimant and disability insurer should not be enforced.
September 29, 2022
Breach Of Contract, Bad Faith Claims Preempted By ERISA, Judge Says

BOSTON — Remand of a disability claimant’s suit seeking to recover disability benefits is not warranted because the state law claims, alleged by the claimant, are preempted by the Employee Retirement Income Security Act, a Massachusetts federal judge said in denying the claimant’s motion to remand.
September 28, 2022
Bifurcation Of Claims Not Warranted In Disability Suit, Ohio Federal Judge Says

COLUMBUS, Ohio — An Ohio federal judge denied a disability insurer’s motion to bifurcate breach of contract and bad faith claims in a disability benefits dispute, rejecting the insurer’s argument that it will be prejudiced if the claims proceed together.
September 23, 2022
District Court Erred In Denying Disability Claimant’s Motion To Supplement Record

PASADENA, Calif. — A district court erred in refusing to allow a disability claimant to supplement the administrative record with additional evidence to counter a disability insurer’s new rationale for terminating the claimant’s long-term disability benefits because the evidence used by the insurer to support its termination was not made available to the claimant before the denial of her administrative appeal, a panel of the Ninth Circuit U.S. Court of Appeals said in reversing and remanding the district court’s ruling.
September 23, 2022
Denial Of LTD Benefits Was Not Abuse Of Discretion, S.C. Federal Judge Finds

SPARTANBURG, S.C. — A disability insurer did not abuse its discretion in denying a claim for long-term disability (LTD) benefits because the claimant did not meet the conditions precedent for coverage under the plan and the disability insurer’s denial was reasonable, a South Carolina federal judge said in granting the insurer’s motion for judgment on the administrative record.
September 22, 2022
Judge Reverses Course, Says Disability Plan Not Governed By ERISA

TUCSON, Ariz. — In light of a recent Ninth Circuit U.S. Court of Appeals ruling, an Arizona federal judge reversed course and determined that a long-term disability (LTD) plan is not governed by the Employee Retirement Income Security Act because the single act of an employer purchasing insurance for an employee does not equate to the establishment of an ERISA plan.
September 19, 2022
7th Circuit Panel Says Disability Insurer, Not Employer, Handled Claims

CHICAGO — The Seventh Circuit U.S. Court of Appeals on Sept. 16 affirmed a district court’s finding that a disability claimant’s former employer did not handle discretionary decisions related to claims for disability benefits and warned the disability claimant, who filed two prior appeals in related lawsuits, that any further frivolous appeals may be subject to monetary sanctions.
September 14, 2022
Termination Of LTD Benefits Not Abuse Of Discretion, Texas Federal Judge Says

HOUSTON — A disability insurer’s termination of benefits was not an abuse of discretion because the insurer’s decision that the claimant was not disabled from performing sedentary work was supported by substantial evidence and was not arbitrary and capricious, a Texas federal judge said Sept. 12.
September 13, 2022
Claimant Met Burden Of Showing He Is Disabled From Working As Attorney

CINCINNATI — A disability claimant met his burden of proving by a preponderance of the evidence that he is unable to work as a personal injury attorney, the Sixth Circuit U.S. Court of Appeals said Sept. 9 in reversing a district court’s finding that the disability insurer’s termination of long-term disability benefits was supported by the medical evidence.
September 07, 2022
Disability Claimant Failed To Show Inability To Perform Duties Of Any Occupation

GRAND RAPIDS, Mich. — A Michigan federal judge on Sept. 6 denied a disability claimant’s motion to reconsider the remand of the claimant’s long-term disability (LTD) claim after determining that the claimant failed to show that he is unable to perform the duties of any gainful occupation.
September 02, 2022
Suit Seeking LTD Benefits Barred By Doctrine Of Res Judicata, Judge Says

SANTA ANA, Calif. — A disability claimant’s suit seeking long-term disability (LTD) benefits is barred by the doctrine of res judicata because the same parties and the same claims are at issue in the claimant’s instant suit as were at issue in the claimant’s prior suit, a California federal judge said Aug. 1 in granting the disability insurer’s motion to dismiss.
August 29, 2022
District Court Properly Found No Disability Benefits Owed, Disability Insurer Says

CHICAGO — A district court correctly found that a disability claimant was not entitled to long-term disability (LTD) benefits because the evidence supports a finding that the claimant did not show by a preponderance that he was unable to perform the duties of his own occupation, a disability insurer contends in its Aug. 24 appellee brief filed in the Seventh Circuit U.S. Court of Appeals.
August 29, 2022
Disability Claimant Failed To File Suit Within 3 Years As Required By Policy

ATLANTA — A district court properly dismissed a disability claimant’s suit alleging that her long-term disability benefits were wrongfully terminated because the claimant failed to file her suit within three years as required by the policy’s three-year suit limitations provision and failed to show that she did not have actual notice of the limitations provision, the 11th Circuit U.S. Court of Appeals said Aug. 25.