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

Mealey's Disability Insurance

January 10, 2024
Evidence Supports Finding That Claimant Is Disabled From Own Occupation

DALLAS — A disability insurer must reinstate a claimant’s long-term disability (LTD) benefits because the preponderance of the evidence supports a finding that the claimant is disabled from performing the material and substantial duties of her own occupation as an insurance agent, a Texas federal judge said in granting the claimant’s motion for judgment on the administrative record.
January 10, 2024
Disability Claimant Is Entitled To LTD Benefits Based On Evidence, Judge Says

ROANOKE, Va. — A Virginia federal judge awarded a claimant long-term disability (LTD) benefits after determining that the disability insurer abused its discretion in denying the claim because sufficient evidence supports a finding that the claimant was disabled prior to the expiration of the disability plan and fulfilled the plan’s terms before filing a claim for LTD benefits.
January 09, 2024
Disability Claimant Awarded More Than $488K In Fees, Costs, Prejudgment Interest

NEW YORK — Following a finding that a disability claimant is owed benefits under a supplemental disability plan, a New York federal judge awarded the claimant more than $488,000 in attorney fees, costs and prejudgment interest after determining that the amounts requested by the claimant were reasonable.
January 09, 2024
Claimant Failed To Show He Was Disabled For Entirety Of Elimination Period

PASADENA, Calif. — A disability insurer properly denied a claim for long-term disability (LTD) benefits because the claimant failed to meet his burden of showing that he was disabled throughout the entire 90-day elimination period as required by the policy and because the record contains no medical evidence contradicting the date for the onset of disability, the Ninth Circuit U.S. Court of Appeals said in affirming a district court’s judgment in favor of the disability insurer.
January 09, 2024
Disability Pension Plan Did Not Act Arbitrarily In Setting Onset Date, 6th Circuit Says

CINCINNATI — A district court did not err in ruling in favor of a disability pension plan trust on the issue of a claimant’s disability onset date because the plan trust correctly determined the disability onset date based on the applicable plan terms, the Sixth Circuit U.S. Court of Appeals said.
January 09, 2024
Transfer Of Disability Suit To West Virginia Is Appropriate, Judge Says

COLUMBUS, Ohio — A disability claimant’s suit must be transferred from Ohio federal court to West Virginia federal court because the claimant failed to show that the disability insurer’s minimum contacts are sufficient for an Ohio federal court to exercise personal jurisdiction over the insurer, an Ohio federal judge said in granting the insurer’s motion to transfer venue.
December 08, 2023
1st Circuit Certifies Question On Suit Limitations Scheme In Disability Policy

BOSTON — The First Circuit U.S. Court of Appeals certified a question to the Rhode Island Supreme Court, asking the high court to answer a question regarding a disability insurance policy’s suit limitations scheme after determining that there are compelling reasons for finding that the policy limitations scheme may run contrary to Rhode Island public policy.
December 08, 2023
Disability Insurer’s Amended Counterclaim Seeking Reimbursement To Proceed

ST. LOUIS — A disability insurer’s amended counterclaim seeking reimbursement from a claimant for an overpayment of disability benefits based on the claimant’s award of Social Security disability benefits can proceed because the insurer sufficiently pleaded a claim for equitable relief, a Missouri federal judge said in denying the claimant’s motion to dismiss the amended counterclaim.
December 08, 2023
Louisiana Federal Judge Remands Disability Claimant’s Suit Seeking LTD Benefits

LAFAYETTE, La. — A Louisiana federal judge adopted a magistrate judge’s recommendation to remand a disability claimant’s suit, agreeing with the magistrate judge’s conclusion that remand is warranted because the federal jurisdictional amount in controversy requirement of $75,000 is not met.
December 08, 2023
Limitation In Disability Income Policy Is Ambiguous, Claimant Tells 9th Circuit

SAN FRANCISCO — A district court erred in finding that a disability income insurer correctly reduced the claimant’s disability income benefits according to the terms of the disability income policy because the policy’s monthly benefit limitation is ambiguous and, therefore, must be construed in favor of the claimant, a disability claimant says in an appellant brief filed in the Ninth Circuit U.S. Court of Appeal.
December 08, 2023
Judge Dismisses Suit After Flight Attendant, Disability Insurer Settle LTD Claim

SAN FRANCISCO — A California federal judge dismissed a disability benefits suit after the parties settled the dispute over a flight attendant’s entitlement to long-term disability (LTD) benefits.
December 07, 2023
Disability Claimant’s Suit Administratively Closed Until Insurer Decides Appeal

DENVER — A Colorado federal judge adopted a magistrate judge’s recommendation to administratively close a disability claimant’s suit seeking a declaration that long-term disability (LTD) benefits are owed under a disability plan to allow the disability insurer to issue a decision on the claimant’s appeal.
December 07, 2023
Judgment Entered For Disability Claimant; Own-Occupation Benefits Owed

SANTA ANA, Calif. — A California federal judge issued a judgment in favor of a disability claimant after determining that the claimant is owed long-term disability (LTD) benefits because the claimant met his burden that he remains disabled from performing the duties of his own occupation.
December 07, 2023
Termination Of LTD Benefits Was Not Abuse Of Discretion, Magistrate Judge Says

PITTSBURGH — A disability plan’s termination of long-term disability (LTD) benefits was not an abuse of discretion because the evidence shows that the claimant was not disabled from performing the duties of any occupation as required by the plan, a Pennsylvania federal magistrate judge said in recommending that the plan’s motion for summary judgment be granted and the claimant’s motion for summary judgment be denied.
December 07, 2023
Disability Claimant Files Notice Of Appeal In Dispute Over ‘Any Occupation’ Benefits

DENVER — A disability claimant filed a notice of appeal to the 10th U.S. Circuit Court of Appeal after a Colorado federal judge ruled that the disability insurer’s termination of the claimant’s disability benefits was reasonable because the insurer fully investigated the claim before concluding that the claimant was not disabled from performing the duties of any occupation.
December 07, 2023
Disability Claimant Seeks High Court Review On Claims Procedure Regulations

WASHINGTON, D.C. — A disability claimant urges the U.S. Supreme Court to grant a petition for writ of certiorari to review whether the Sixth Circuit U.S. Court of Appeals properly determined whether violations of claims procedure regulations under the Employee Retirement Income Security Act can be excused if the disability plan claims administrator substantially complied with the regulations.
December 07, 2023
Disability Plan Did Not Abuse Discretion In Terminating LTD Benefits, Judge Says

MINNEAPOLIS — A disability plan did not abuse its discretion in terminating a claimant’s long-term disability (LTD) benefits after four years of paying the claimant benefits because substantial evidence, including a statement from the claimant’s treating doctor that he was able to return to work, supports the plan’s decision, a federal judge in Minnesota said.
November 20, 2023
9th Circuit Finds No Error In Judgment Entered In Favor Of Disability Insurer

SAN JOSE, Calif. — The Ninth Circuit U.S. Court of Appeals affirmed a district court’s judgment in favor of a disability insurer, rejecting the disability claimant’s argument that the lower court adopted new rationales that were not included in the administrative record in finding that the insurer’s termination of benefits was reasonable based on the evidence.
November 14, 2023
Disability Claimant’s Suit Cannot Proceed; Panel Says Claims Are Time-Barred

NEW ORLEANS — A district court properly found that a disability claimant’s suit cannot proceed because the claims alleged against the disability insurer are barred by the applicable statutes of limitations, the Fifth Circuit U.S. Court of Appeals said in affirming the lower court’s ruling.
November 10, 2023
Alabama Federal Judge Refuses To Deviate From Precedent In Disability Suit

JASPER, Ala. — An Alabama federal judge denied motions to determine the appropriate standard of review in a disability benefits dispute filed by the disability insurer and disability claimant after determining that neither of the parties persuaded the court to deviate from the precedent set forth in an 11th Circuit U.S. Court of Appeals’ suit when determining the appropriate standard of review.
November 09, 2023
Panel Affirms Disability Insurer’s Benefits Termination Was Arbitrary, Capricious

PHILADELPHIA — The Third Circuit U.S. Court of Appeals on Nov. 8 affirmed a district court’s ruling that a disability insurer acted arbitrarily and capriciously in terminating a disability claimant’s benefits because the insurer wrongfully reclassified the claimant’s occupation as an internal medical specialist after more than 10 years of correctly classifying the claimant’s occupation as a gastroenterologist.
November 09, 2023
Federal Magistrate Judge Strikes Filings Submitted By Disability Claimant

PORTLAND, Maine — A federal magistrate judge in Maine on Nov. 8 granted a disability insurer’s motion to strike two filings submitted by a disability claimant because the claimant did not seek leave of the court before submitting the filings, which were not permitted pursuant to the court’s scheduling order.
November 10, 2023
Panel Refuses To Review District Court Decision In Disability Benefits Dispute

PHILADELPHIA — While acknowledging that a district court’s appointment of an independent medical expert to examine a disability claimant suffering from fibromyalgia and rheumatoid arthritis is “highly unusual,” the Third Circuit U.S. Court of Appeals refused to grant a disability insurer’s petition for a writ of mandamus because the district court indicated that the purpose of the appointment is to reinforce the district court’s belief that remand of the claim is the appropriate form of relief.
November 10, 2023
Airline Pilot Files Complaint Seeking Disability Benefits For Long-Haul COVID-19

PHILADELPHIA — A disability insurer abused its discretion and breached its duty to a commercial airline pilot suffering from the effects of long-haul COVID-19 when it denied the pilot’s claim for long-term disability (LTD) benefits, the pilot claims in a complaint filed in Pennsylvania federal court.
November 09, 2023
Insured’s Disability Income Suit Barred By Policy’s Suit Limitations Provision

ATLANTA — A suit against a disability income insurer is barred by the policy’s three-year suit limitations provision because the insured failed to file the breach of contract and bad faith suit within three years of his claim for benefits being denied, the 11th Circuit U.S. Court of Appeals said in affirming a district court’s ruling.