Mealey's Disability Insurance
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November 09, 2023
Bad Faith Claim In Disability Suit Cannot Proceed, Judge Says
SAN DIEGO — A bad faith claim alleged against a disability insurer cannot proceed because the insured failed to show that the insurer acted unreasonably and because the insurer showed that a genuine issue of fact existed on the cause of the insured’s disability, a California federal judge said in partly granting the disability insurer’s motion for summary judgment.
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November 08, 2023
Parties In Disability Suit Allowed To File Administrative Record Under Seal
CINCINNATI — An Ohio federal judge granted a joint motion to seal the administrative record in a disability benefits suit after determining that the protection of the disability claimant’s private health information outweighs the public’s interest in having access to the records and documents in the administrative record.
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November 08, 2023
Magistrate Judge Recommends Disability Insurer’s Motion For Judgment Be Granted
CHATTANOOGA, Tenn. — A disability insurer’s termination of a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the medical evidence supported the insurer’s termination of benefits and the insurer “provided a reasoned basis” for its termination, a Tennessee federal magistrate judge said in recommending that the insurer’s motion for judgment as a matter of law (JMOL) be granted and the claimant’s motion for JMOL be denied.
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November 08, 2023
Disability Claimant Awarded $42K In Attorney Fees After 9th Circuit’s Remand
SEATTLE — A Washington federal judge determined that a disability claimant is entitled to $42,000 in attorney fees based on the fact that she achieved some success on the merits in her long-term disability (LTD) benefits suit, which was remanded by the Ninth Circuit U.S. Court of Appeals.
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November 07, 2023
Disability Insurer’s Benefits Termination Was Not Arbitrary, Capricious, Judge Says
CHATTANOOGA, Tenn. — A disability claimant failed to show that a disability insurer’s reliance on the opinions of its staff physicians was arbitrary and capricious or that the insurer’s conflict of interest affected its decision to terminate the claimant’s benefits, a Tennessee federal judge said Nov. 6 in adopting a magistrate judge’s report and recommendation to grant the insurer’s motion for judgment on the administrative record.
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October 18, 2023
Former NBA Player Alleges Disability Insurer Breached Contract, Acted In Bad Faith
CHARLOTTE, N.C. — A former National Basketball Association (NBA) player alleges in a complaint filed in North Carolina federal court that his disability insurer acted in bad faith and breached its contract by denying his disability benefits claim because he was rendered totally and permanently disabled by a diagnosis of myopericarditis, an inflammation of the lining of his heart, following two bouts with COVID-19.
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October 10, 2023
5th Circuit Says Former NFL Player Not Entitled To Additional Disability Benefits
NEW ORLEANS — Even though the denial of a claim for additional disability benefits under the National Football League (NFL) plan seems “disturbing,” the Fifth Circuit U.S. Court of Appeals said reversal of a district court’s ruling in favor of an ex-NFL 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.
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October 06, 2023
1st Circuit Panel Says Termination Of Disability Pension Benefits Was Reasonable
BOSTON — The First Circuit U.S. Court of Appeals affirmed a district court’s finding that the termination of disability pension benefits was reasonable because the pension plan made numerous attempts to verify the claimant’s contention that he did not engage in disqualifying employment while receiving the benefits.
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October 06, 2023
New York Federal Judge Says Questions Of Fact Exist In Disability Benefits Suit
NEW YORK — A New York federal judge denied motions for summary judgment filed by a disability claimant and a disability insurer after determining that genuine disputes of material fact exist over the claimant’s job duties and the medical opinions regarding the claimant’s disabling conditions.
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October 06, 2023
LTD Benefits Reinstated; Claimant Presented Evidence Supporting Disability
PORTLAND, Ore. — A disability claimant’s long-term disability (LTD) benefits were reinstated by an Oregon federal judge because the claimant presented the disability insurer with requested evidence that supports a finding that she was disabled from performing the duties of her occupation.
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October 06, 2023
New York Federal Judge Transfers Disability Claimant’s Suit To Utah Federal Court
NEW YORK — A New York federal judge transferred a disability claimant’s wrongful denial of benefits suit to Utah federal court after determining that Utah is the more appropriate venue because the disability claimant and the claimant’s treating physicians are all located in Utah.
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October 06, 2023
Disability Plan Is ERISA Plan; Safe Harbor Doesn’t Apply, Judge Rules
CLEVELAND — A disability plan is governed by the Employee Retirement Income Security Act, a federal judge in Ohio ruled, concluding that the plan did not fall under ERISA’s safe harbor exemption because the employer initially paid the plan premiums and those payments were not illusory despite the employer’s issuance of a Form 1099 to the disability claimant.
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October 06, 2023
Fees Reduced, Costs Denied In ERISA Disability Case That Settled
MADISON, Wis. — A federal judge in Wisconsin reduced the attorney fees awarded to a disability claimant who sued to have her long-term disability benefits reinstated because the case settled before dispositive motions were filed and found that the issuer of the policy should not be responsible for increased costs resulting from the claimant’s “halting, piecemeal approach to recovering her attorney fees.”
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October 04, 2023
Preexisting Conditions Exclusion Applies Based On Prior Treatment, Judge Says
ATLANTA — A disability insurer’s denial of a long-term disability (LTD) claim was reasonable because the policy’s preexisting conditions exclusion bars coverage, a Georgia federal judge said after determining that an actual diagnosis for a sickness for which the claimant was treated prior to becoming an insured under the disability plan is not required for the exclusion to apply.
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October 04, 2023
Disability Claimant’s Suit Barred By Applicable Statute Of Limitations, Judge Says
PHOENIX — An Arizona federal judge terminated a disability claimant’s suit after determining that the claimant failed to file suit within three years as required by the policy or within six years as provided under Arizona law for contractual claims.
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October 04, 2023
Disability Claimant’s Suit Dismissed Following Settlement Reached During Mediation
SAN FRANCISCO — A California federal judge dismissed a disability claimant’s suit seeking a declaration that she is entitled to long-term disability (LTD) benefits after the claimant and the disability insurer agreed to a settlement during a mediation proceeding.
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October 03, 2023
Federal Magistrate Judge Awards Disability Claimant $42,851 In Attorney Fees
MADISON, Wis. — A Wisconsin federal magistrate judge awarded a disability claimant more than $42,000 in attorney fees after determining that a 40% overall reduction in the billed amount of fees was necessary despite the claimant’s success on the merits of his long-term disability (LTD) benefits claim.
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September 21, 2023
Disability Claimant Met Burden Of Showing She Remains Disabled, Judge Says
OAKLAND, Calif. — A disability claimant met her burden of proving by a preponderance of the evidence that she remains disabled from performing the duties of any occupation, a California federal judge said in granting the claimant’s motion for judgment and in denying the disability insurer’s motion for judgment.
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September 20, 2023
LTD Insurer’s Termination Of Benefits Supported By Medical Evidence, Judge Says
WEST PALM BEACH, Fla. — A disability insurer’s termination of a long-term disability (LTD) claim must be upheld because the insurer’s finding that the claimant was no longer disabled from performing the duties of any occupation is supported by objective medical evidence, a Florida federal judge said in granting the insurer’s motion for summary judgment.
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September 08, 2023
Kentucky Federal Judge Partially Grants Disability Claimant’s Motion For Judgment
LEXINGTON, Ky. — A Kentucky federal judge partially granted a disability claimant’s motion for judgment on the administrative record in a disability suit that has been pending in court since 2015 after determining that the insurer’s denial of benefits for a claim submitted before Jan. 1, 2015, was arbitrary and capricious.
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September 08, 2023
Disability Claimant Entitled To LTD Benefits, 6th Circuit Says In Reversing Ruling
CINCINNATI — The Sixth Circuit U.S. Court of Appeals reversed a district court’s ruling in favor of a disability insurer and remanded the suit with instructions to award a disability claimant long-term disability (LTD) benefits because the insurer’s finding that the claimant was not disabled from performing the duties of any occupation is not supported by credible medical evidence.
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September 08, 2023
Disability Insurer’s Petition For Permission To Appeal Is Untimely, Panel Says
PHILADELPHIA — The Third Circuit U.S. Court of Appeals denied a disability insurer’s petition for permission to appeal a Pennsylvania federal judge’s ruling in a disability class action suit because the insurer failed to file the petition within 14 days of the original class certification order as required by Federal Rule of Civil Procedure 23(f).
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September 08, 2023
LTD Insurer’s Denial Of Claim Was Correct, Magistrate Judge Says
GALVESTON, Texas — A Texas federal magistrate judge recommended granting a disability insurer’s motion for judgment on the administrative record after determining that the insurer’s denial of a long-term disability (LTD) claim was correct and supported by the medical evidence.
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September 08, 2023
Disability Benefits Claim Denial Was Not Arbitrary, Capricious, Judge Says
PORTLAND, Maine — The denial of a long-term disability (LTD) claim was not arbitrary and capricious because the denial of benefits was reasonable and supported by substantial evidence, a Maine federal judge said in denying the claimant’s motion for judgment on the administrative record and in granting the disability plan’s motion for judgment.
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September 08, 2023
Claims Against Disability Plan Fail, Kentucky Federal Judge Determines
PADUCAH, Ky. — A Kentucky federal judge dismissed a disability plan participant’s claims against a disability plan after determining that the disability claimant failed to show that the plan misstated the amount of long-term disability (LTD) benefits available to the claimant.