Mealey's Disability Insurance
-
December 08, 2022
Disability Insurer’s Decision To Terminate Benefits Not Arbitrary, Capricious
WICHITA, Kan. — A disability insurer’s termination of benefits based on its plan’s two-year limitation for mental health disorders was not arbitrary and capricious because the insurer’s decision was reasonable and based on substantial evidence, a Kansas federal judge said.
-
December 08, 2022
Disability Insurer Seeks To Stay Suit To Allow Appeal Of Class Certification Order
WILLIAMSPORT, Pa. — A disability insurer filed a motion to stay proceedings in a suit pending in Pennsylvania federal court arising out of the insurer’s right to reimbursement from a claimant who recovered damages from a tortfeasor in an auto accident to allow the insurer to file an appeal in the Third Circuit U.S. Court of Appeal of a federal judge’s class certification order.
-
December 07, 2022
Doctor Says LTD Benefits Owed For Inability To Work Based On COVID-19 Risks
ATLANTA — A disability insurer arbitrarily and capriciously denied a doctor’s claim for long-term disability (LTD) benefits because substantial evidence supports a finding that the doctor, who suffered from a number of medical conditions, was unable to work as a physician based on his high risk of contracting COVID-19 and experiencing severe complications from the virus based on his medical diagnoses, the doctor says in a complaint filed in Georgia federal court.
-
December 07, 2022
Claimant Met Burden Of Showing She Is Disabled From Sedentary Occupation
LOS ANGELES — A disability claimant is entitled to long-term disability (LTD) benefits, a California federal judge said after determining that the claimant showed by a preponderance of the evidence that she is more than likely disabled from performing the duties of a sedentary occupation.
-
December 07, 2022
Disability Insurer Entitled To Costs For Deposition Transcripts, Judge Says
LOUISVILLE, Ky. — A Kentucky federal judge awarded a disability insurer approximately $1,644 in costs for deposition transcripts costs after determining that the award of costs is appropriate and that the disability claimant failed to demonstrate that an award of costs is unreasonable or unnecessary.
-
December 07, 2022
Suit Limitation Provision Bars Disability, Bad Faith Suit, 3rd Circuit Panel Says
PHILADELPHIA — A district court correctly concluded that an insured’s breach of contract and bad faith suit against a disability insurer is barred by the policy’s three-year suit limitation provision because the insured failed to file the suit within three years after the expiration of the 90-day appeal period following the termination of her disability benefits, the Third Circuit U.S. Court of Appeals said Dec. 6.
-
December 06, 2022
Disability Insurer’s Termination Of Benefits Was Reasonable Based On Evidence
MADISON, Wis. — A Wisconsin federal judge determined that a disability insurer’s termination of long-term disability (LTD) benefits based on its finding that the claimant was no longer disabled from performing the duties of her own occupation was reasonable based on the medical evidence and the claimant’s failure to provide objective medical evidence in support of her functional limitations.
-
December 05, 2022
Illinois Law Applies To Breach Of Contract, Bad Faith Claims In Disability Suit
LOS ANGELES — A California judge determined that Illinois law must be applied to breach of contract and bad faith claims in a suit filed against a disability income insurer because the policy was issued in Illinois, includes a choice-of-law provision designating Illinois law as the applicable law and does not contravene any fundamental policy of California.
-
November 29, 2022
Disability Claimant’s Attorneys Awarded More Than $48,000 In Fees
WORCESTER, Mass. — A Massachusetts federal judge on Nov. 28 partially granted a disability claimant’s motion for attorney fees and costs, awarding the claimant’s attorneys more than $48,000 after finding that a reduction in the number of hours logged and a reduction in the hourly rates charged by the attorney were necessary.
-
November 29, 2022
9th Circuit Dismisses Disability Insurer’s Appeal Pursuant To Stipulation
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals dismissed a disability insurer’s appeal of a district court’s judgment entered in favor of a disability claimant following the disability insurer’s filing of a stipulation to dismiss the appeal with prejudice.
-
November 23, 2022
District Court Improperly Engaged In New Determination Of Claimant’s Disability
PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals determined that a district court’s finding that a disability insurer correctly denied a claim for long-term disability (LTD) benefits must be reversed because the court improperly engaged in a new determination regarding the claimant’s disability rather than simply examining the insurer’s rationale for denying the benefits claim.
-
November 21, 2022
Disability Insurer Breached Contract, Acted In Bad Faith, Insured Says In Complaint
SEATTLE — A disability insurer breached its contract and acted in bad faith by failing to properly calculate the amount of residual disability benefits available under two long-term disability policies, an insured maintains in a complaint filed in Washington federal court.
-
November 11, 2022
Claimant Met Burden Of Showing Own-Occupation Benefits Are Owed
SACRAMENTO, Calif. — A disability claimant is entitled to long-term disability (LTD) benefits under a plan’s own-occupation standard because the evidence supports a finding that the claimant was disabled from performing the duties of her own occupation; however, the disability insurer must determine on remand if the claimant qualifies for LTD benefits under the plan’s any-occupation standard, a California federal judge said.
-
November 11, 2022
Settlement Reached In COVID-19 Disability Benefits Suits, Parties Tell Court
ATLANTA — A disability insurer has agreed to settle a disability claimant’s suit alleging that the insurer wrongfully denied long-term disability (LTD) benefits to the claimant for complications related to a COVID-19 infection.
-
November 11, 2022
Questions Of Fact Exist On Whether Claimant Was Totally Disabled, Judge Says
COLUMBUS, Ohio — An Ohio federal judge denied a disability claimant’s motion for judgment on the pleadings after determining that questions of fact exist regarding whether the claimant was totally disabled from his own occupation.
-
November 11, 2022
Termination Of Benefits Was Not Abuse Of Discretion, Magistrate Judge Says
HOUSTON — A disability plan administrator did not abuse its discretion in terminating a claimant’s long-term disability (LTD) benefits after determining that the claimant was not disabled from performing the duties of any occupation because the administrator properly weighed differing opinions from physicians, a Texas federal magistrate judge said in recommending that the claimant’s motion for judgment on the administrative record be denied and that the suit be dismissed.
-
November 10, 2022
Disability Claimant Awarded Attorney Fees; Case Reopened To Consider Latest Denial
LEXINGTON, Ky. — A Kentucky federal judge determined that a disability claimant is entitled to approximately $48,000 in attorney fees based on the claimant’s success on the merits and reopened the claimant’s suit after determining that the claimant exhausted all administrative remedies pertaining to the insurer’s most recent denial of disability benefits.
-
November 10, 2022
Disability Claimant Entitled To LTD Benefits For Heart Condition, Judge Says
LOS ANGELES — A disability claimant is entitled to long-term disability (LTD) benefits because the medical evidence supports a finding that the claimant was totally disabled and the disability insurer failed to consider how work-related stress could negatively contribute to the claimant’s heart condition, a California federal judge said.
-
November 10, 2022
Disability Insurer Not Entitled To Award Of Attorney Fees, Judge Says
NEW YORK — Despite a long-term disability insurer’s success on the merits, a New York federal judge denied the insurer’s motion for attorney fees because there is no evidence of bad faith or culpability on the part of the claimant and an award of attorney fees in favor of the insurer would likely deter plan participants from filing valid claims in disability disputes.
-
November 09, 2022
Suit Seeks Recalculation Of Disability Benefits, Is Time-Barred, Judge Says
NEW YORK — A disability claimant’s suit seeking a recalculation of residual disability benefits is time-barred because the claimant failed to file suit within three years as required by the disability policies at issue, a New York federal judge said.
-
November 07, 2022
Bad Faith Claim Against Disability Insurer To Proceed Under California Law
SAN DIEGO — A bad faith claim against a disability insurer will proceed because applying Illinois law would be contrary to California’s fundamental policy of providing a remedy for insurance bad faith, a California federal judge said in denying the insurer’s motion to dismiss the bad faith claim.
-
November 07, 2022
Disability Insurer Properly Relied On Surveillance Videos, 10th Circuit Panel Says
DENVER — A disability insurer properly relied on surveillance videos in determining that a claimant was no longer disabled from performing the duties of any occupation, the 10th Circuit U.S. Court of Appeals said in affirming a district court’s judgment in favor of the insurer.
-
October 26, 2022
Disability Insurer’s Benefits Termination Supported By Substantial Evidence
BLUEFIELD, W.Va. — A disability insurer’s termination of long-term disability benefits after 14 years of paying benefits was not unreasonable, a West Virginia federal judge said in finding that substantial evidence supported the insurer’s determination that the claimant was capable of working in a sedentary occupation.
-
October 18, 2022
Disability Claimant Appeals Judgment Entered In Disability Insurer’s Favor
MIAMI — A disability claimant filed a notice of appeal to the 11th Circuit U.S. Court of Appeals after a Florida federal judge determined that the claimant failed to show by a preponderance of the evidence that he remained disabled under the terms of the disability plan at issue.
-
October 11, 2022
Substantial Evidence Supports Finding That Claimant Not Disabled From Any Occupation
CINCINNATI — A disability plan’s denial of long-term disability benefits was not arbitrary and capricious because substantial evidence supported the plan’s determination that the claimant was not disabled from performing the duties of any occupation, the Sixth Circuit U.S. Court of Appeals said in affirming a district court’s opinion.