Mealey's Disability Insurance
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May 26, 2022
Judgment Properly Granted In Favor Of Disability Insurer, Panel Affirms
ATLANTA — A district court properly granted judgment in favor of a disability insurer because the disability claimant failed to prove that he was continuously disabled throughout the plan’s elimination period, a necessary requirement to qualify for long-term disability (LTD) benefits, the 11th Circuit U.S. Court of Appeals said May 24.
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May 25, 2022
Insurer Breached Contract In Denying Surgeon’s Total Disability Benefits Claim
CHICAGO — A disability insurer breached its contract in denying a claim for total disability benefits because the claimant was unable to perform the duties of his primary occupation as a liver transplant surgeon; however, the insurer did not unreasonably deny coverage, an Illinois federal judge said May 20.
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May 24, 2022
9th Circuit Reverses, Remands Denial Of Attorney Fees In Disability Suit
PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on May 20 reversed a district court’s denial of a disability claimant’s motion for attorney fees after determining that the district court failed to properly view the remand of a long-term disability benefits claim as constituting some success on the merits.
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May 17, 2022
Insurer Wrongfully Denied LTD Benefits For COVID Long-Haul Symptoms, Claimant Says
SEATTLE — A disability insurer wrongfully denied long-term disability benefits to an employee suffering from COVID-19 long-haul symptoms because the employee is unable to perform the duties of her own occupation as a result of her symptoms, the employee claims in a May 13 complaint filed in Washington federal court.
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May 13, 2022
Plan’s Decision To Terminate Disability Benefits Was Reasonable, Panel Says
CHICAGO — A panel of the Seventh Circuit U.S. Court of Appeals on May 11 affirmed a district court’s ruling in favor of a disability plan after determining that the decision to terminate a claimant’s short-term disability benefits was not arbitrary and capricious; however, the panel reversed the lower court’s award in favor of the plan for pro hac vice admission fees after determining that those fees are not taxable costs.
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May 05, 2022
Termination Of Disability Benefits Was Reasonable, Federal Judge Determines
TAMPA, Fla. — A disability insurer did not act arbitrarily and capriciously in terminating a disability claimant’s benefits because the insurer reasonably concluded that the claimant was capable of working in a sedentary occupation and not disabled from performing the duties of any occupation, a Florida federal judge said March 31.
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May 05, 2022
Intentional Infliction Of Emotional Distress Claim To Proceed In Disability Suit
SAN DIEGO — A California federal judge on April 20 determined that a claim for intentional infliction of emotional distress alleged by a disability claimant can proceed because the claimant raised questions of fact regarding the outrageousness of the conduct of a third-party administrator’s agent and the severity of the emotional distress experienced by the claimant who became homeless following the denial of her claim for disability benefits.
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May 05, 2022
Disability Claimant Is Entitled To LTD Benefits Under Plan’s Own-Occupation Standard
RENO, Nev. — A disability claimant is entitled to the reinstatement of long-term disability (LTD) benefits under his health care plan’s own-occupation standard because the disability insurer abused its discretion in determining that the claimant failed to provide medical evidence in support of his disability, a Nevada federal judge said March 24 in granting the claimant’s motion for summary judgment.
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May 04, 2022
Administrative Record In Disability Suit Permitted To Be Filed Under Seal
OXFORD, Miss. — A Mississippi federal magistrate judge on May 3 granted a disability insurer’s unopposed motion to file an administrative record under seal because the more than 1,700-page record contains personal and confidential information protected from disclosure by state and federal law.
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May 03, 2022
Claimant Remained Disabled And Was Unable To Perform Duties Of Any Occupation
SEATTLE — A disability insurer’s termination of long-term disability benefits is not supported by the medical evidence in the administrative record, a Washington federal judge said May 2 after determining that the disability claimant met his burden of proving by a preponderance of the evidence that he remained physically disabled and unable to perform the duties of any occupation.
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May 03, 2022
Ohio Federal Judge Grants Disability Plan’s Motion For Stay Of Execution
CINCINNATI — An Ohio federal judge on April 26 granted a disability plan’s motion to stay the execution of a judgment entered against it until the plan’s appeal is resolved by the Sixth Circuit U.S. Court of Appeals because the plan posted a bond that covers the judgment entered against it in addition to up to 12 months of additional long-term disability (LTD) benefits and post-judgment interest.
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May 03, 2022
Magistrate: Disability Claimant Failed To State Claim For Relief Under ERISA
PORTLAND, Maine — A federal magistrate judge in Maine on April 12 recommended dismissing a disability claimant’s complaint after determining that the claimant failed to state a plausible claim for relief under the Employee Retirement Income Security Act.
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May 03, 2022
Claim For LTD Benefits Is Moot Based On Reinstatement Of Benefits Without Offset
AUSTIN, Texas — A Texas federal magistrate judge on April 13 determined that a disability plan participant’s claim for long-term disability (LTD) benefits is moot based on a disability insurer’s reinstatement of benefits without an offset but said that the disability claimant should be entitled to collect prejudgment interest on the amount of benefits to which the offset was applied.
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April 29, 2022
Disability Claimant Alleges Insurer Breached Contract In Terminating Benefits
WEST PALM BEACH, Fla. — A disability claimant alleges in an April 12 complaint filed in Florida federal court that a disability insurer breached its contract in terminating payments for long-term disability (LTD) income benefits and in terminating a waiver of premiums owed for the disability and life insurance policies issued to the claimant.
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April 29, 2022
Disability Insurer Failed To Provide Full, Fair Review, Claimant Says In Complaint
TAMPA, Fla. — A disability insurer wrongfully denied a claim for long-term disability (LTD) benefits in violation of the Employee Retirement Income Security Act and failed to provide a full and fair review of the claim as required by ERISA, a disability claimant alleges in an April 20 complaint filed in Florida federal court.
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April 25, 2022
Disability Claimant Seeks Review Of Ruling From 10th Circuit Appeals Court
DENVER — A disability claimant filed a notice of appeal on April 6, seeking review from the 10th Circuit U.S. Court of Appeals of a district court’s ruling that her insurer’s termination of long-term disability (LTD) benefits based on its finding that the claimant was not physically disabled from performing the duties of any occupation was not arbitrary and capricious and was supported by substantial evidence.
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April 22, 2022
Disability Claimant Not Entitled To Information Related To Peer Reviews
WASHINGTON, D.C. — A District of Columbia federal judge on April 19 denied a disability claimant’s motion to compel information related to peer reviews conducted by a disability insurer after determining that the claimant failed to meet his burden of showing that the information is relevant.
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April 20, 2022
Limited Discovery Permitted In Disability Benefits Suit, Arizona Federal Judge Says
PHOENIX — Limited discovery into a disability insurer’s reserves and the training and experience of the insurer’s employees will be permitted in a disability dispute, an Arizona federal judge said April 18 after determining that the disability claimant has shown that the information is relevant to the disability claimant’s assertion that the insurer’s structural conflict of interest influenced the administration of her claim.
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April 14, 2022
Panel Says Insurer’s Calculation Of Date Of Disability Was Reasonable
CHICAGO — The Seventh Circuit U.S. Court of Appeals on April 11 reversed a district court’s grant of summary judgment in favor of a disability claimant after determining that the disability insurer’s determination of the claimant’s first day of disability and the salary on which the claimant’s long-term disability (LTD) benefits should be based was reasonable and not arbitrary and capricious.
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April 08, 2022
Disability Claimant Deprived Of Full, Fair Review, Federal Judge Determines
WORCESTER, Mass. — A disability insurer’s failure to disclose reports completed by two of its independent physicians deprived the claimant of a full and fair review, a Massachusetts federal judge said March 7 in remanding the claim to allow the claimant the opportunity to respond to the reports.
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April 08, 2022
Termination Of LTD Benefits Was Not Arbitrary, Capricious, Federal Judge Determines
CHATTANOOGA, Tenn. — A disability insurer’s decision to terminate a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s finding that the claimant was not disabled from performing the duties of any occupation is supported by substantial evidence in the administrative record, a Tennessee federal judge said Feb. 23.
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April 07, 2022
Evidence Supports Disability Insurer’s Termination Of LTD Benefits, Judge Says
TAMPA, Fla. — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s finding that the claimant was no longer disabled from performing the duties of any occupation was supported by the evidence, a Florida federal judge said April 5.
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April 06, 2022
Judge Remands Disability Claim To Determine Whether Claimant Remained Disabled
NEW YORK — A New York federal judge on March 30 granted a disability insurer’s motion for reconsideration and remanded a long-term disability (LTD) claim to the plan administrator to determine whether a claimant was disabled from performing the duties of her own occupation after the date on which the administrative record closed.
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April 05, 2022
Termination Of Long-Term Disability Benefits Was Not Arbitrary, Capricious
GREEN BAY, Wis. — A disability insurer’s termination of long-term disability benefits based on its finding that the claimant was not disabled from performing the duties of any occupation was not arbitrary and capricious because the insurer did not ignore evidence in finding that the claimant was no longer disabled, a Wisconsin federal judge said April 4 in denying the claimant’s motion for judgment on the administrative record.
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April 05, 2022
In Reversal, 9th Circuit Says Insurer Didn’t Meet Burden On Reasonableness
PHOENIX — A Ninth Circuit U.S. Court of Appeals panel on March 29 reversed and remanded an Arizona federal judge’s grant of summary judgment in a bad faith case, ruling in an unpublished memorandum disposition that holding a long-term disability policy to be part of an employee welfare benefit plan under the Employee Retirement Income Security Act was an error, and so was concluding that the insurer’s actions were reasonable as a matter of law.