Mealey's Disability Insurance
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September 06, 2024
Amici File Briefs Urging High Court To Review NFL Disability Benefits Suit
WASHINGTON, D.C. — Three amicus curiae briefs, filed in the U.S. Supreme Court in support of a former National Football League player’s petition for a writ of certiorari, urge the high court to review the Fifth Circuit U.S. Court of Appeals’ ruling that the former NFL player failed to prove he is entitled to additional disability benefits under the NFL’s benefits plan, arguing that a de novo standard of review applies based on the plan’s procedural violations.
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September 06, 2024
Utah Federal Judge Denies Disability Claimant’s Motion To Reopen Disability Suit
SALT LAKE CITY — A Utah federal judge denied a disability claimant’s motion to reopen a disability suit after determining that the claimant is required to file a civil enforcement action under the Employee Retirement Income Security Act because the dispute is centered on the disability insurer’s calculation of benefits.
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September 06, 2024
Disability Plan’s Special Conditions Limitation Rider Bars LTD Benefits Claim
BALTIMORE — A Maryland federal judge on Sept. 5 granted a disability insurer’s motion for summary judgment after determining that the disability plan’s special conditions limitation rider applies as a bar to the disability claimant’s long-term disability (LTD) benefits.
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September 06, 2024
Disability Claimant Failed To Show Termination Of Benefits Was Arbitrary, Capricious
NEW YORK — A disability insurer’s termination of a long-term disability (LTD) benefits claim was not arbitrary and capricious because nothing in the medical record reviewed by the insurer and its reviewing physicians supported a finding that the claimant was disabled from working on a full-time basis, a New York federal magistrate judge said in recommending that the insurer’s motion for summary judgment be granted and that the disability claimant’s motion for summary judgment be denied.
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September 06, 2024
Default Judgment Entered Against Disability Claimant For Failure To Repay Plan
CINCINNATI — A plan administrator is entitled to default judgment on a breach of fiduciary duty claim alleged against a disability claimant who failed to reimburse the long-term disability (LTD) plan for the overpayment of benefits following the claimant’s award of Social Security disability benefits because the claimant failed to respond to the plan administrator’s suit and breached his fiduciary duty by not repaying the plan as required by the plan’s terms, an Ohio federal judge said.
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September 05, 2024
Denial Of Attorney Fee Award To Disability Claimant Was Proper, Panel Says
CINCINNATI — A district court did not abuse its discretion in denying a disability claimant’s motion for attorney fees because the claimant failed to carry his burden of showing that the attorney fees he sought to recover were reasonable, the Sixth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.
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September 05, 2024
Breach Of Contract, Bad Faith Suit Against Disability Insurer Remanded
MILWAUKEE — A Wisconsin federal magistrate judge remanded an insured’s breach of contract and bad faith suit against a disability insurer and an independent insurance agent after determining that the agent was not fraudulently joined as a defendant to defeat the diversity of citizenship requirement because the insured’s negligent misrepresentation claim against the agent alleges sufficient facts in support of the claim.
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September 04, 2024
Attorney Fees, Costs Not Warranted, Minnesota Federal Judge Says
MINNEAPOLIS — A Minnesota federal judge denied a disability claimant’s motion for attorney fees and costs after determining that an award of fees and costs is not warranted because no other plan participant will benefit from the claimant’s suit and the suit did not resolve an important legal question.
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August 30, 2024
Disability Insurer’s Alleged Conduct Does Not Support Request For Punitive Damages
RIVERSIDE, Calif. — An insured’s request for punitive damages against a disability insurer must be dismissed because the insured’s complaint does not allege conduct that supports punitive damages, a California federal judge said in granting the insurer’s motion to dismiss the request without prejudice.
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August 21, 2024
High Risk Of Developing Complications From COVID-19 Rendered Doctor Disabled
SAN FRANCISCO — A disability insurer’s denial of a pediatrician’s long-term disability (LTD) benefits claim was de novo wrong because the pediatrician’s high risk of exposure to COVID-19 and high risk of developing complications from the virus based on her underlying medical issues rendered her disabled from performing the duties of her own occupation, a California federal judge said in granting the pediatrician’s motion for judgment on the administrative record.
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August 15, 2024
Fact Issue Exists On Cause Of Disability Claimant’s Symptoms, Judge Says
FORT MYERS, Fla. — A Florida federal judge partially denied a disability insurer’s motion for summary judgment after determining that a question of fact exists as to whether the insured received regular medical care from the appropriate medical professional for symptoms of shakiness and motor tics.
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August 09, 2024
LTD Insurer Must Pay Retroactive, Future Benefits, Minnesota Federal Judge Says
MINNEAPOLIS — A disability plan participant is entitled to retroactive long-term disability (LTD) benefits and future LTD benefits because the plan participant met her burden of proving by a preponderance of the evidence that cognitive difficulties rendered her disabled from performing the duties of her own occupation as an attorney, a Minneapolis federal judge said in granting the plan participant’s motion for judgment on the administrative record.
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August 08, 2024
LTD Insurer’s Denial Of Benefits Was Not Abuse Of Discretion, Judge Says
PHILADELPHIA — A long-term disability (LTD) insurer did not abuse its discretion in denying a claim for LTD benefits because the claimant did not suffer any lost income based on the employer’s decision to continue paying the employee after he stopped working, a Pennsylvania federal judge said Aug. 7 in granting the insurer’s motion for summary judgment.
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August 07, 2024
District Court Erred In Finding Disability Plan Abused Its Discretion, Panel Says
PHILADELPHIA — A district court erred in finding that a disability plan abused its discretion when it terminated a claimant’s long-term disability (LTD) benefits for failure to provide proof of a continued disability because the plan properly considered all of the medical evidence and properly interpreted the plan’s “own occupation” language, the Third Circuit U.S. Court of Appeals said Aug. 6 in vacating and remanding the district court’s opinion.
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August 06, 2024
Disability Claimant Says Award Of Benefits, Not Remand, Is Appropriate Remedy
BALTIMORE — Reconsideration of a Maryland federal judge’s decision to remand a long-term disability (LTD) benefits claim is warranted because an award of benefits, rather than remand of the claim, is the appropriate form of relief, a disability claimant says in a reply brief in support of her motion for partial reconsideration of the judge’s ruling.
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August 06, 2024
Former NFL Player’s Motion To Reinstate Appeal Over Disability Benefits Granted
ATLANTA — The 11th Circuit U.S. Court of Appeals on Aug. 5 granted a former National Football League player’s motion to reinstate his appeal in a dispute over additional disability benefits owed under the NFL’s disability plan.
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August 06, 2024
Disability Insurer’s Denial Of LTD Claim Was Not De Novo Wrong, Judge Says
FORT MYERS, Fla. — A disability insurer’s denial of a long-term disability (LTD) claim was not de novo wrong because its decision is supported by the evidence in the administrative record and the claimant failed to provide any evidence to rebut the insurer’s basis for denial, a Florida federal judge said in granting the insurer’s motion for summary judgment.
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August 06, 2024
Denial Of STD Claim Reasonable Based On Lack Of Evidence, Federal Judge Says
BIRMINGHAM, Ala. — The denial of a short-term disability (STD) benefits claim following a treating physician’s failure to respond to the STD claims administrator’s repeated requests regarding the claimant’s medical condition and the claimant’s ability to return to work was reasonable and not wrong, an Alabama federal judge said in granting the disability plan defendants’ motion for summary judgment and in denying the claimant’s motion for summary judgment.
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August 05, 2024
Disability Claimant’s Suit Dismissed For Failure To Name Proper Defendant
SAN JUAN, Puerto Rico — A disability claimant’s suit against her former employer and disability plan administrator must be dismissed because the defendants are not the proper defendants as neither of the named defendants was responsible for making disability claims decisions under the short-term disability (STD) plan, a Puerto Rico federal judge said Aug. 2 in granting the defendants’ motion to dismiss.
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August 02, 2024
STD, LTD Claims Remanded To Plan Administrator For Full, Fair Review
LOUISVILLE, Ky. — The denial of claims for short-term disability (STD) and long-term disability (LTD) benefits was arbitrary and capricious because the denials were not the result of a deliberate and principled reasoning process, a Kentucky federal judge said in remanding the claims to the plan administrator for a full and fair review.
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August 01, 2024
District Court Properly Found Disability Claimant Is Totally Disabled, 8th Circuit Says
ST. LOUIS — A district court did not err in granting judgment in favor of a disability claimant because the claimant met her burden of showing that she is disabled from performing the duties of any occupation, the Eighth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.
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July 29, 2024
Bad Faith Claim Against Disability Insurer Cannot Proceed, Judge Says
FORT SMITH, Ark. — A bad faith claim alleged against a disability insurer cannot proceed because the disability claimant fails to allege sufficient facts in support of the claim and the complaint alleges only that a disagreement exists over the insurer’s denial of his long-term disability (LTD) claim, an Arkansas federal judge said.
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July 29, 2024
Disability Claimant’s Suit Fails; Policy Rider Clearly Stated Terms, Judge Says
LOS ANGELES — A California federal judge granted a disability insurer’s motion for summary judgment and dismissed a breach of contract and bad faith suit filed against a disability income insurer after determining that the insurer’s termination of cost-of-living benefits was proper pursuant to the terms of the policy rider and its termination provision.
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July 29, 2024
Ex-NFL Player Seeks High Court Review, Says Wrong Standard Of Review Applied
WASHINGTON, D.C. — A former National Football League player filed a petition for writ of certiorari in the U.S. Supreme Court, contending that the high court should review the Fifth Circuit U.S. Court of Appeals’ ruling that he failed to prove that he is entitled to additional disability benefits under the NFL’s benefits plan because a de novo standard of review should have been applied based on the plan’s procedural violations.
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July 29, 2024
NFL Disability Plan Says Former Player’s Appeal Should Not Be Reinstated
ATLANTA — The 11th Circuit U.S. Court of Appeals should summarily deny a former National Football League player’s motion to reinstate his appeal in a dispute over additional disability benefits owed under the NFL’s disability plan because the motion is untimely and because the former player failed to show any good cause to excuse the untimeliness of the appeal, the NFL plan maintains in response to the former player’s motion.