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March 06, 2024
OWENSBORO, Ky. — A disability claimant’s long-term disability (LTD) benefits must be reinstated because the disability insurer’s termination of benefits is not supported by the medical evidence, a Kentucky federal judge said in granting the disability claimant’s motion for judgment.
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March 06, 2024
HUNTSVILLE, Ala. — An Alabama federal judge awarded a disability claimant more than $11,000 in costs after determining that the claimant is entitled to recover the costs because she is the prevailing party on a breach of contract claim asserted against her disability insurer.
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March 06, 2024
DALLAS — A Texas federal judge remanded a claim for long-term disability (LTD) benefits to the plan administrator after determining that the claimant was deprived of a full and fair review based on the disability insurer’s failure to consult with a different physician regarding the claimant’s appeal following the termination of her claim.
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February 20, 2024
WASHINGTON, D.C. — The U.S. Supreme Court on Feb. 20 denied a disability claimant’s petition for writ of certiorari seeking review of 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.
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February 09, 2024
NEW YORK — A former regional sales manager filed suit in New York federal court, seeking a ruling that he is entitled to long-term disability (LTD) benefits for post-COVID-19 syndrome under a disability plan sponsored by his employer because the plan administrator’s denial of benefits was contrary to the weight of the medical and vocational evidence.
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February 08, 2024
PHILADELPHIA — A district court’s judgment in favor of a disability claimant should be reversed because substantial evidence shows that the claimant did not meet her burden of proving that she was disabled from performing the duties of her own occupation following three ankle surgeries, the disability plan says in its appellant brief filed in the Third Circuit U.S. Court of Appeals.
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February 08, 2024
ALEXANDRIA, Va. — A disability insurer reasonably applied a limited benefit provision in finding that a claimant’s migraine headaches entitled her to only 24 months of benefits; however, the insurer’s explanation for its denial of benefits for the claimant’s cervical radiculopathy was not consistent, a Virginia federal judge said in determining that remand of claimant’s cervical radiculopathy claim is warranted.
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February 07, 2024
BALTIMORE — A Maryland federal judge on Feb. 6 denied a plan administrator’s motion to dismiss claims for breach of fiduciary duty after determining that a disability claimant sufficiently alleged facts in support of the claims pertaining to the long-term disability (LTD) and life insurance plans at issue.
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February 07, 2024
DALLAS — Following a Texas federal judge’s ruling that a disability claimant’s long-term disability (LTD) benefits must be reinstated, the parties reached a settlement of the LTD benefits dispute and filed a joint stipulation of dismissal with prejudice.
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February 07, 2024
SAN FRANCISCO — A disability insurer fails to show that a rider included in its disability income policy is not ambiguous and should be enforced, a disability claimant says, maintaining in his appellant reply brief filed in the Ninth Circuit U.S. Court of Appeals that a district court incorrectly interpreted the policy’s monthly benefit rider.
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February 06, 2024
DENVER — A disability insurer breached its fiduciary duty in terminating a claim for long-term disability (LTD) benefits because the insurer mischaracterized the claimant’s medical condition and failed to follow the plan’s guidelines and procedures in handling the claim, a disability claimant alleges in a complaint filed Feb. 5 in Colorado federal court.
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February 06, 2024
DENVER — A disability claimant alleges in a Feb. 5 complaint filed in Colorado federal court that a disability insurer acted improperly, arbitrarily and capriciously in terminating her long-term disability (LTD) benefits based on a finding that she was not disabled from performing the duties of any occupation.
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February 01, 2024
CEDAR RAPIDS, Iowa — An Iowa federal judge remanded a disability claimant’s long-term disability (LTD) claim to the disability plan administrator after determining that the claimant was deprived of a full and fair review because the claimant was not afforded the opportunity to respond to new information used by the disability insurer in denying the claimant’s appeal.
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February 01, 2024
MADISON, Wis. — A disability insurer’s denial of benefits was not arbitrary and capricious because the medical evidence supports the insurer’s finding that the claimant was not disabled from performing the duties of her own occupation, a Wisconsin federal judge said in entering summary judgment in favor of the insurer.
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January 31, 2024
LOS ANGELES — A disability claimant failed to prove by a preponderance of the evidence that she is entitled to short-term disability (STD) and long-term disability (LTD) benefits because she failed to provide any objective findings in support of her claimed disability, California federal judge said in granting judgment in favor of the disability insurer.
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January 25, 2024
MADISON, Wis. — A disability insurer did not act arbitrarily and capriciously in denying a claim for long-term disability (LTD) benefits because the evidence in the record supports the insurer’s conclusion that the claimant failed to provide objective medical evidence in support of her LTD claim, a Wisconsin federal judge said.
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January 24, 2024
PORTLAND, Maine — A federal judge in Maine granted a disability insurer’s motion for judgment on the administrative record after determining that the insurer did not act arbitrarily or capriciously or abuse its discretion by offsetting a claimant’s benefits to recover an overpayment because the plan terms clearly permitted the insurer to offset the benefits.
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January 23, 2024
PASADENA, Calif. — A disability claimant’s suit seeking long-term disability (LTD) benefits is not barred by the doctrine of res judicata because the claim pertaining to the denial of the claimant’s LTD benefits had not accrued when the claimant filed her first suit, the majority of the Ninth Circuit U.S. Court of Appeals said Jan. 22 in reversing a district court’s ruling in favor of the disability insurer.
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January 12, 2024
WEST PALM BEACH, Fla. — A disability insurer reasonably weighed conflicting medical evidence regarding a claimant’s ability to work in her own occupation before denying her claim for short-term disability (STD) benefits, a Florida federal magistrate judge said in finding that the insurer’s denial of benefits was not arbitrary and capricious.
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January 12, 2024
SEATTLE — A Washington federal judge awarded a disability claimant more than $94,000 in attorney fees based on the claimant’s success in showing that she is entitled to long-term disability (LTD) benefits under a disability plan.
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January 12, 2024
TULSA, Okla. — An Oklahoma federal judge remanded a short-term disability (STD) claim to a plan administrator for clarification on the issue of why the plan administrator denied a disability claimant’s second appeal following the termination of his STD benefits.
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January 12, 2024
SANTA ANA, Calif. — Following a disability claimant’s successful appeal on a breach of fiduciary duty claim and subsequent settlement with the disability insurer, a California federal judge entered final judgment in the suit and awarded the claimant more than $312,000 in attorney fees after applying a reduction to the number of hours billed by the claimant’s counsel.
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January 11, 2024
ALLENTOWN, Pa. — A insured’s claim for violation of Pennsylvania’s Unfair Trade Practices and Consumer Protection Law (UTPCPL) alleged against a disability insurer must be dismissed because the claim is not actionable under the UTPCPL as it alleges only a refusal to pay a disability insurance claim, a Pennsylvania federal judge said in granting the insurer’s motion to dismiss the claim without prejudice.
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January 11, 2024
PASADENA, Calif. — A district court erred in finding that a claimant was not disabled beyond a certain date because the medical evidence does not show that there was any improvement in the claimant’s heart-related condition, the Ninth Circuit U.S. Court of Appeals said in reversing the lower court’s ruling.
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January 11, 2024
SALT LAKE CITY — A disability claimant’s suit is barred by Utah’s three-year statute of limitations for claims stemming from insurance contracts because the claimant failed to filed suit within three years as required by the statute, a Utah federal judge said, noting that it was not necessary to interpret the policy’s three-year limitations provision based on the claimant’s argument that she never received a final claims denial letter from the insurer.