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

Mealey's Disability Insurance

April 25, 2022
Disability Claimant Seeks Review Of Ruling From 10th Circuit Appeals Court

DENVER — A disability claimant filed a notice of appeal on April 6, seeking review from the 10th Circuit U.S. Court of Appeals of a district court’s ruling that her insurer’s termination of long-term disability (LTD) benefits based on its finding that the claimant was not physically disabled from performing the duties of any occupation was not arbitrary and capricious and was supported by substantial evidence.
April 22, 2022
Disability Claimant Not Entitled To Information Related To Peer Reviews

WASHINGTON, D.C. — A District of Columbia federal judge on April 19 denied a disability claimant’s motion to compel information related to peer reviews conducted by a disability insurer after determining that the claimant failed to meet his burden of showing that the information is relevant.
April 20, 2022
Limited Discovery Permitted In Disability Benefits Suit, Arizona Federal Judge Says

PHOENIX — Limited discovery into a disability insurer’s reserves and the training and experience of the insurer’s employees will be permitted in a disability dispute, an Arizona federal judge said April 18 after determining that the disability claimant has shown that the information is relevant to the disability claimant’s assertion that the insurer’s structural conflict of interest influenced the administration of her claim.
April 14, 2022
Panel Says Insurer’s Calculation Of Date Of Disability Was Reasonable

CHICAGO — The Seventh Circuit U.S. Court of Appeals on April 11 reversed a district court’s grant of summary judgment in favor of a disability claimant after determining that the disability insurer’s determination of the claimant’s first day of disability and the salary on which the claimant’s long-term disability (LTD) benefits should be based was reasonable and not arbitrary and capricious.
April 08, 2022
Disability Claimant Deprived Of Full, Fair Review, Federal Judge Determines

WORCESTER, Mass. — A disability insurer’s failure to disclose reports completed by two of its independent physicians deprived the claimant of a full and fair review, a Massachusetts federal judge said March 7 in remanding the claim to allow the claimant the opportunity to respond to the reports.
April 08, 2022
Termination Of LTD Benefits Was Not Arbitrary, Capricious, Federal Judge Determines

CHATTANOOGA, Tenn. — A disability insurer’s decision to terminate a claimant’s long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s finding that the claimant was not disabled from performing the duties of any occupation is supported by substantial evidence in the administrative record, a Tennessee federal judge said Feb. 23.
April 07, 2022
Evidence Supports Disability Insurer’s Termination Of LTD Benefits, Judge Says

TAMPA, Fla. — A disability insurer’s termination of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer’s finding that the claimant was no longer disabled from performing the duties of any occupation was supported by the evidence, a Florida federal judge said April 5.
April 06, 2022
Judge Remands Disability Claim To Determine Whether Claimant Remained Disabled

NEW YORK — A New York federal judge on March 30 granted a disability insurer’s motion for reconsideration and remanded a long-term disability (LTD) claim to the plan administrator to determine whether a claimant was disabled from performing the duties of her own occupation after the date on which the administrative record closed.
April 05, 2022
Termination Of Long-Term Disability Benefits Was Not Arbitrary, Capricious

GREEN BAY, Wis. — A disability insurer’s termination of long-term disability benefits based on its finding that the claimant was not disabled from performing the duties of any occupation was not arbitrary and capricious because the insurer did not ignore evidence in finding that the claimant was no longer disabled, a Wisconsin federal judge said April 4 in denying the claimant’s motion for judgment on the administrative record.
April 05, 2022
In Reversal, 9th Circuit Says Insurer Didn’t Meet Burden On Reasonableness

PHOENIX — A Ninth Circuit U.S. Court of Appeals panel on March 29 reversed and remanded an Arizona federal judge’s grant of summary judgment in a bad faith case, ruling in an unpublished memorandum disposition that holding a long-term disability policy to be part of an employee welfare benefit plan under the Employee Retirement Income Security Act was an error, and so was concluding that the insurer’s actions were reasonable as a matter of law.
April 04, 2022
Disability Claimant Cannot Recover Emotional Distress Damages, Judge Says

BATON ROUGE, La. — A disability claimant cannot seek nonpecuniary damages for emotional distress as a result of the termination of her disability benefits because there is no evidence supporting the claimant’s argument that she was aggrieved by the insurers handling her disability benefits claim, a Louisiana federal judge said March 31 in granting the insurers’ motion for partial summary judgment.
April 04, 2022
High Court Refuses To Review Finding That Claimant Failed To Prove Disability

WASHINGTON, D.C. — The U.S. Supreme Court on April 4 denied a disability claimant’s petition for writ of certiorari, refusing to consider the Ninth Circuit U.S. Court of Appeals’ finding that the disability claimant failed to prove that he was disabled from his own occupation as a result of sickness or injury according to the plan’s terms and pursuant to a de novo standard of review.
April 01, 2022
Disability Claimant Permitted To Assert Breach Of Contract, Bad Faith Claims

PHOENIX — An Arizona federal judge on March 29 granted a disability claimant’s motion to amend a complaint to add state law claims of breach of contract and bad faith after determining that complete briefing is necessary to determine whether the disability plan at issue is a church plan under the Employee Retirement Income Security Act.
March 31, 2022
Breach Of Contract Counterclaim Is Preempted By ERISA, Judge Says

CINCINNATI — A disability insurer’s breach of contract counterclaim arising out of a claimant’s refusal to reimburse the insurer for an overpayment of disability benefits is preempted under the Employee Retirement Income Security Act and must be dismissed, an Ohio federal judge said March 22 in granting the claimant’s motion to dismiss the counterclaim.
March 29, 2022
Denial Of LTD Benefits Was Not Arbitrary, Capricious, Utah Federal Judge Says

SALT LAKE CITY — A disability insurer did not act arbitrarily and capriciously in denying a claim for long-term disability (LTD) benefits because substantial medical evidence supports the insurer’s denial of benefits, a Utah federal judge said March 21 in granting the insurer’s motion for summary judgment.
March 29, 2022
Disability Insurer Breached Fiduciary Duty In Terminating Benefits, Claimant Says

NEW YORK — A disability insurer breached its fiduciary duty in terminating a disability claimant’s long-term disability (LTD) benefits based on its finding that the claimant failed to submit proof of a positive COVID-19 test or proof of COVID-19 antibodies because the insurer failed to request proof of a positive test or antibodies test when it initially approved the claimant’s LTD benefits for COVID-19 long hauler syndrome, the claimant alleges in a March 13 complaint filed in New York federal court.
March 28, 2022
Denial Of LTD Benefits Was Arbitrary, Capricious, Federal Judge Finds

MADISON, Wis. — A Wisconsin federal judge on March 24 granted a disability claimant’s motion for summary judgment and remanded the long-term disability (LTD) claim to the plan administrator after determining that the denial of benefits was not supported by the medical evidence and was arbitrary and capricious.
March 28, 2022
Denial Of LTD Claim Was Not Abuse Of Discretion, 9th Circuit Panel Says

PASADENA, Calif. — A disability plan administrator did not abuse its discretion in denying a claim for long-term disability (LTD) benefits because the medical records did not support a finding that the claimant was disabled from performing the duties of his own occupation or the duties of any occupation, the Ninth U.S. Circuit Court of Appeals said March 10.
March 16, 2022
Breach Of Contract, Bad Faith Claims Properly Dismissed Against Disability Insurer

NEW ORLEANS — A district court did not err in dismissing a disability claimant’s breach of contract and bad faith claims against a disability insurer because the claimant failed to offer sufficient facts in support of the breach of contract and bad faith claims, the Fifth Circuit U.S. Court of Appeals said March 15.
March 11, 2022
Medical Evidence Supports Disability Insurer’s Termination Of LTD Benefits

SACRAMENTO, Calif. — A California federal judge on Feb. 18 denied a disability claimant’s motion for judgment and granted a disability insurer’s motion for judgment after determining that the medical evidence supports the insurer’s termination of benefits based on the conclusion that the claimant was no longer disabled from performing the duties of his own occupation.
March 11, 2022
Disability Plan Did Not State Continued Social Security Benefits Were Necessary

CHICAGO — A disability plan’s termination of long-term disability (LTD) benefits was arbitrary and capricious because the plan did not state that continued Social Security Administration (SSA) disability benefits were necessary in order to continue to receive LTD benefits, an Illinois federal judge said Feb. 28 in granting the claimant’s motion for summary judgment.
March 11, 2022
Disability Benefits Owed Under Plan’s Own-Occupation Standard, Judge Says

SACRAMENTO, Calif. — A disability claimant is entitled to long-term disability (LTD) benefits for the full 24-month period permitted under the plan’s own-occupation standard because the claimant met his burden of proving by a preponderance of the evidence that he was disabled from performing the duties of his own occupation, a California federal judge said Feb. 15.
March 10, 2022
Denial Of LTD Benefits Was Arbitrary, Capricious, Federal Judge Determines

CHATANOOGA, Tenn. — A Tennessee federal judge on March 9 granted a disability claimant’s motion for judgment on the administrative record and remanded the claim to the plan administrator after determining that the disability insurer’s denial of long-term disability (LTD) benefits was arbitrary and capricious because the insurer disregarded the opinion of the claimant’s treating doctor who was the only physician to physically examine the claimant.
March 10, 2022
Administrative Record In Disability Suit To Be Filed Under Seal, Judge Says

SEATTLE — A Washington federal judge on March 9 granted a joint motion to seal the administrative record in a disability benefits suit after determining that protecting the disability claimant’s privacy interests outweighs any public interest in accessing the records.
March 09, 2022
Judge Says Jury Instruction On Disability Insurers’ Burden Of Proof Is Allowed

FORT MYERS, Fla. — A Florida federal judge on Feb. 23 granted a disability claimant’s motion to include a jury instruction stating that defendant disability insurers carry the burden of proving the claimant’s disability under Florida law because the insurers terminated the claimant’s benefits.