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

Mealey's Disability Insurance

April 04, 2024
Disability Insurer Must Reinstate Claimant’s LTD Benefits, Judge Says

MINNEAPOLIS — A Minnesota federal judge ordered a disability insurer to reinstate a claimant’s long-term disability (LTD) benefits after determining that the insurer failed to show that a lack of objective medical evidence supported its termination of benefits.
April 03, 2024
Panel: Court Properly Found Termination Of Benefits Was Not Arbitrary, Capricious

NEW YORK — A district court properly entered judgment in favor of a disability insurer because the insurer’s termination of a claimant’s benefits under the disability plan’s any occupation standard was not arbitrary and capricious, the Second Circuit U.S. Court of Appeals said April 2.
April 03, 2024
Disability Claimant Owed LTD Benefits Under Own-Occupation Standard, Judge Says

NEW YORK — A disability claimant is entitled to long-term disability (LTD) benefits for the first 24 months of his disability because the evidence supports a finding that the claimant is disabled from the duties of his own occupation, a New York federal judge said in granting the claimant’s motion for judgment on the administrative record.
April 02, 2024
Disability Claimant’s Suit Reopened To Determine If Plan Complied With Remand Order

TULSA, Okla. — An Oklahoma federal judge reopened a disability claimant’s suit to consider whether the disability plan administrator failed to follow the court’s remand order regarding clarification of the plan’s denial of the claimant’s short-term disability (STD) claim.
April 02, 2024
Denial Of STD Benefits Claim Was Not Arbitrary, Capricious, Judge Says

SALT LAKE CITY — A disability insurer’s denial of short-term disability (STD) benefits was not arbitrary and capricious because the disability claimant failed to submit sufficient evidence showing that he was entitled to benefits, a Utah federal judge concluded in granting the insurer’s motion for summary judgment.
March 29, 2024
Panel Enters Judgment For Disability Claimant; Opinion Temporarily Filed Under Seal

PITTSBURGH — A panel of the Third Circuit U.S. Court of Appeals issued judgment in favor of a disability claimant, vacating and remanding a district court’s ruling in favor of the disability plan; however, the panel filed the opinion under seal to allow the parties to submit proposed redactions.
March 28, 2024
Trial Court Properly Awarded Sanctions To Disability Insurer, California Panel Says

SANTA ANA, Calif. — A trial court properly sustained a disability insurer’s demurrer of an insured’s breach of contract and bad faith suit and properly awarded sanctions to the disability insurer because the suit was the third suit filed against the insurer and the insured failed to meet his burden of showing that the third suit was not frivolous or without merit, the Fourth District California Court of Appeals said.
March 25, 2024
Disability Claimant Met Burden Of Proving He Remained Disabled Under Terms Of Plan

KNOXVILLE, Tenn. — A disability claimant met his burden of proving by a preponderance of the evidence that he remained disabled as a result of multiple sclerosis and that his long-term disability (LTD) benefits were improperly terminated, a Tennessee federal judge said in granting he claimant’s motion for judgment on the administrative record.
March 25, 2024
Medical Doctor Is Entitled To Additional LTD Benefits For Post-Viral Complications

MINNEAPOLIS — A medical doctor who suffered post-viral complications from a suspected case of COVID-19 is entitled to additional long-term disability (LTD) benefits because she met her burden of showing that she was partially disabled for the entirety of 2021.
March 22, 2024
Federal Judge Awards Disability Claimant More Than $187K In Attorney Fees

NEW YORK — A New York federal judge awarded a disability claimant more than $187,000 in attorney fees after finding that the award is warranted based on the claimant’s success on the merits of his claims for disability benefits and waiver of life insurance premium benefits and after applying a 10% reduction to the billed attorney fee rates and a 5% reduction to the billed number of hours.
March 20, 2024
Termination Of Benefits Was Not Arbitrary, Capricious, New York Federal Judge Says

WHITE PLAINS, N.Y. — Substantial evidence supports a disability insurer’s finding that a disability claimant is not disabled from performing the duties of any occupation, a New York federal judge said, noting that an independent medical exam report and multiple independent peer review reports support the disability insurer’s determination.
March 19, 2024
Disability Insurer’s Denial Of Benefits Was Not De Novo Wrong, Judge Says

TAMPA, Fla. — A disability insurer’s denial of disability benefits was not de novo wrong because the disability claimant failed to show that he was disabled prior to his retirement, a Florida federal judge said March 18.
March 18, 2024
5th Circuit Majority Denies Ex-NFL Player’s Petition For Rehearing En Banc

NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals denied a former National Football League (NFL) player’s petition for panel rehearing and the majority of the court denied rehearing en banc, voting 11-5 against rehearing en banc, and issued a substituted opinion on March 15, reiterating that a district court’s ruling in favor of the former player must be reversed because the former player failed to show that he had any changed circumstances that would entitle him to additional disability benefits under the plan.
March 15, 2024
Termination Of LTD Benefits Was Result Of Deliberate Reasoning Process, Panel Says

CINCINNATI — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s decision was the result of a deliberate and principled reasoning process and was supported by substantial medical evidence, the Sixth Circuit U.S. Court of Appeals said in affirming a district court’s opinion.
March 13, 2024
Oral Surgeon’s Breach Of Contract, Bad Faith Claims Against Disability Insurer Fail

FRESNO, Calif. — An insured’s breach of contract and bad faith claims against a disability insurer cannot proceed because there is no evidence that any doctor advised the insured to stop working as an oral surgeon to reduce the risk of contracting COVID-19 and suffering complications from the virus based on his comorbid conditions of asthma and hypertension.
March 08, 2024
Claimant Says Additional LTD Benefits Are Owed Under Disability Plan

PORTLAND, Maine — In a March 7 complaint filed in Maine federal court, a disability claimant maintains that she is entitled to unpaid long-term disability (LTD) benefits under a disability plan because she remains disabled under the terms of the plan.
March 08, 2024
District Court’s Decision Should Be Affirmed, Disability Claimant Maintains

PHILADELPHIA — A district court’s judgment in favor of a disability claimant should be affirmed because the court properly found that the plan’s termination of the claimant’s long-term disability (LTD) benefits was arbitrary and capricious and that the decision was inadequate for a number of reasons, the claimant says in an appellee brief filed in the Third Circuit U.S. Court of Appeals.
March 08, 2024
Disability Insurer’s Interpretation Of Plan Terms Was Incorrect, Judge Says

KANSAS CITY, Kan. — A Kansas federal judge granted a disability claimant’s motion for summary judgment after determining that the claimant is owed disability benefits under his employer’s disability plan because the disability insurer’s interpretation of the plan terms regarding eligibility of coverage was incorrect.
March 08, 2024
Disability Claimant Failed To Meet Burden Of Proving Disability, Judge Says

LAS VEGAS — A disability claimant failed to meet his burden of proving that he was disabled from performing the duties of his regular occupation as an attorney, a Nevada federal judge held after determining that the long-term disability (LTD) insurer engaged in meaningful dialogue with the claimant and did not abuse its discretion in denying the claim for LTD benefits.
March 08, 2024
Parties Settle Long-Haul COVID Disability Dispute; Dismissal Order Entered

BOSTON — A Massachusetts federal judge entered an order of dismissal after the parties in a dispute over the availability of long-term disability (LTD) benefits for long-haul COVID symptoms notified the court that they reached a settlement.
March 07, 2024
Exhaustion Of Remedies Under LTD Plan Not Required Prior To Filing Suit

TACOMA, Wash. — A disability insurer’s motion for judgment on the pleadings must be denied because the long-term disability (LTD) plan at issue did not require the disability claimant to exhaust all administrative remedies prior to filing suit, a Washington federal judge concluded in denying the insurer’s motion.
March 07, 2024
Judge Refuses To Compel Disability Claimant To Exhaust Administrative Remedies

PORTLAND, Ore. — An Oregon federal judge denied a disability plan’s motion to compel a disability claimant to exhaust all administrative remedies because the disability plan failed to adhere to the 45-day deadline for deciding a claimant’s appeal of a long-term disability (LTD) benefits claim and failed to show that a special circumstance existed that warranted an extension to the 45-day deadline.
March 06, 2024
Disability Insurer Abused Its Discretion In Denying LTD Benefits, Judge Determines

ALEXANDRIA, Va. — A disability insurer abused its discretion in denying a claim for long-term disability (LTD) benefits because the insurer failed to consider the opinions of the claimant’s treating physicians and failed to consider whether the claimant’s heart condition and health would deteriorate if he was forced to work in a high-stress job, a Virginia federal judge said in granting the claimant’s motion for summary judgment and denying the insurer’s motion for summary judgment.
March 06, 2024
Award Of Attorney Fees, Costs Not Warranted Based On Remand Of Claim, Judge Says

TULSA, Okla. — A disability claimant is not entitled to an award of attorney fees or costs based on the remand of the claimant’s short-term disability (STD) claim to the plan administrator because the remand order was a procedural ruling and does not constitute a success on the merits of the claim, an Oklahoma federal judge said in denying the claimant’s motion for an award of attorney fees and costs.
March 06, 2024
LTD Benefits Must Be Reinstated, Kentucky Federal Judge Says

OWENSBORO, Ky. — A disability claimant’s long-term disability (LTD) benefits must be reinstated because the disability insurer’s termination of benefits is not supported by the medical evidence, a Kentucky federal judge said in granting the disability claimant’s motion for judgment.