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Mealey's Disability Insurance

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • July 26, 2024

    Parties Stipulate To Dismissal Of Long COVID Disability Benefits Suit After Settlement

    MIAMI — Following a second order issued by a Florida federal judge, the parties in a long-term disability (LTD) benefits suit stemming from a claimant’s diagnosis with long COVID filed a joint stipulation of dismissal on July 25 after settling the LTD claim.

  • July 24, 2024

    Disability Insurer Permitted To File Entire Administrative Record Under Seal

    CINCINNATI — A disability insurer is permitted to file the entire administrative record in a disability benefits suit under seal because redaction of the sensitive and confidential information from the record would be time consuming and burdensome and filing the administrative record under seal would ensure that the claimant’s personal and confidential information remains protected, an Ohio federal judge said in granting the parties’ joint motion to file the administrative record under seal.

  • July 23, 2024

    Disability Claimant Deprived Of Full, Fair Review, Florida Federal Judge Says

    MIAMI — A Florida federal judge on July 22 remanded a long-term disability (LTD) claim to the plan administrator after determining that the claimant was deprived of a full and fair review because the disability insurer issued a decision on appeal without affording the claimant the opportunity to respond to two reports upon which it relied when terminating the claimant’s benefits.

  • July 17, 2024

    California Judge Dismisses LTD Plan From Suit, Leaving Insurer As Sole Defendant

    OAKLAND, Calif. — A California federal judge dismissed a long-term disability (LTD) plan from a disability claimant’s suit, leaving the disability insurer as the sole defendant after the parties jointly agreed to dismiss the plan as a defendant.

  • July 17, 2024

    Panel Affirms Ruling In Favor Of Disability Claimant, Says Denial Was De Novo Wrong

    ATLANTA — A disability insurer’s denial of a medical doctor’s long-term disability (LTD) benefits claim was de novo wrong because the insurer construed the policy language referring to compensation from a medical partnership without considering the context of the policy language as a whole, the 11th Circuit U.S. Court of Appeals said in affirming a district court’s summary judgment ruling entered in favor of a disability claimant.

  • July 08, 2024

    LTD Claim Remanded To Allow Claimant To Respond To Independent Peer Reviews

    MINNEAPOLIS — A Minnesota federal judge remanded a long-term disability (LTD) claim to allow a disability claimant to respond to independent peer reviews conducted by the disability insurer and to submit additional evidence in response to the peer reviews.

  • July 05, 2024

    Pro Se Litigant’s Disability Suit Was Properly Dismissed, 6th Circuit Affirms

    CINCINNATI — The Sixth Circuit U.S. Court of Appeals on July 3 affirmed a district court’s dismissal of a pro se disability claimant’s suit after determining that the claimant was afforded the opportunity to allege claims under the Employee Retirement Income Security Act but failed to do so in accordance with the district court’s directives.

  • July 05, 2024

    Failure To Consider Cognitive Issues Was Abuse Of Discretion, Federal Judge Says

    BALTIMORE — A Maryland federal judge determined that a disability insurer abused its discretion in terminating a disability claimant’s long-term disability (LTD) benefits because the insurer failed to consider how the claimant’s cognitive issues affect her ability to work in her regular occupation.