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

Mealey's Disability Insurance

March 09, 2022
Medical Evidence Supports Finding That Disability Claimant Was Totally Disabled

CHICAGO — An Illinois federal judge on Feb. 16 granted a disability claimant’s motion for judgment on the administrative record after determining that the medical evidence and the claimant’s deteriorating health condition support a finding that the claimant was totally disabled from performing the duties of her occupation.
March 09, 2022
Judge Rejects Disability Insurer’s Objections To Inclusion Of Therapist’s Letter

CENTRAL ISLIP, N.Y. — Noting that a disability benefits suit has been going on for far too long, a New York federal judge on Feb. 17 denied a disability insurer’s objections to the inclusion in the record of a letter from a physical therapist who completed the claimant’s functional capacity evaluation and encouraged the parties to consider other approaches to bring the suit to finality.
March 07, 2022
Disability Claimant Met Burden Of Showing She Is Disabled From Own Occupation

NEW YORK — A disability claimant met her burden of proving by a preponderance of the evidence that she was disabled from performing the duties of her own occupation under the terms of a disability plan, a New York federal judge said March 3 after determining that subjective and objective medical evidence supports the claimant’s disability.
March 07, 2022
Administrative Record In Disability Benefits Suit To Be Sealed, Judge Says

CINCINNATI — An Ohio federal judge on March 4 granted a disability insurer’s unopposed motion to seal the administrative record after determining that the insurer met its burden of showing that protection of the claimant’s private health information outweighs any public interest in the disclosure of the information.
March 04, 2022
Disability Claimant Failed To Show That Termination Of Benefits Was Incorrect

CINCINNATI — A district court did not err in entering judgment in favor of a disability insurer because the disability claimant failed to show that the lower court erroneously found that the insurer’s termination of benefits was incorrect based on the evidence, the Sixth Circuit U.S. Court of Appeals said Feb. 22.
March 04, 2022
Change In Disability Benefits Was Not Arbitrary, Capricious, 6th Circuit Says

CINCINNATI — A district court did not err in finding that a disability plan and its administrator did not act arbitrarily and capriciously in determining that a plan participant was no longer totally disabled and, instead, only partially disabled because the medical evidence supports the plan’s decision, the Sixth Circuit U.S. Court of Appeals said Feb. 24.
February 22, 2022
District Court Erred In Awarding Disability Benefits, Panel Says In Remanding

NEW ORLEANS — The Fifth Circuit U.S. Court of Appeals on Feb. 18 vacated and remanded a district court’s award of almost $195,000 in disability benefits to a disability claimant after determining that the lower court should have remanded the claim to the plan administrator to determine the amount of benefits owed to the claimant.
February 22, 2022
High Court Denies Review Of Disability Claimant’s Petition On Choice Of Law

WASHINGTON, D.C. — The U.S. Supreme Court on Feb. 22 denied a disability claimant’s petition for writ of certiorari seeking a “uniform rule enforcing an ERISA plan’s choice of law” and a ruling that the Employee Retirement Income Security Act does not preempt state law prescribing de novo judicial review for challenged benefit determinations.
February 15, 2022
Question Of Fact Exists As To Disability Claimant’s Medical Specialty, Judge Says

SAN FRANCISCO — A California federal judge on Feb. 10 denied a disability claimant’s motion for summary judgment in a breach of contract and bad faith lawsuit after determining that a question of fact exists as to whether the claimant’s occupation was limited to that of a pediatric anesthesiologist.
February 10, 2022
Disability Claimant’s Suit Not Filed Within 3 Years As Required, Judge Determines

SAN FRANCISCO — A California federal judge on Jan. 12 dismissed a breach of contract and bad faith lawsuit filed against a disability insurer after determining that the claimant’s suit seeking disability benefits for pain following a voluntary bone marrow donation is untimely as it was not filed within three years as required by the policy.
February 10, 2022
Question Of Fact Exists As To Whether Disability Insurer Waived Payment Deadline

PHOENIX — An Arizona federal judge on Jan. 31 determined that questions of fact exists as to whether a disability income insurer waived its right to cancel an insured’s policy based on a late payment because a fact finder could find that the insurer’s prior acceptance of premium payments made after the 31-day grace period is evidence of the insurer’s waiver of the premium payment deadline.
February 10, 2022
Disability Insurers Did Not Act In Bad Faith In Denying LTD Claim

PHILADELPHIA — A Pennsylvania federal judge on Feb. 9 dismissed a bad faith claim alleged against two disability insurers after determining that the insurers had a reasonable basis to deny the insured’s claim for additional long-term disability (LTD) benefits.
February 09, 2022
Good Cause Exists To Extend Discovery Deadline In Disability Benefits Suit

ASHEVILLE, N.C. — A North Carolina federal judge on Feb. 8 granted a disability claimant’s request to extend a discovery deadline after determining that good cause exists for extending the deadline and allowing the disability insurer to respond to the claimant’s discovery requests.
February 09, 2022
Federal Judge Awards Prejudgment Interest, Attorney Fees In Disability Suit

CINCINNATI — An Ohio federal judge on Jan. 31 determined that a disability claimant is entitled to a 3.5% prejudgment interest rate on the claimant’s long-term disability (LTD) benefits incurred after Jan. 24, 2020, and determined that the claimant is entitled to more than $130,000 in additional attorney fees following a 33% reduction in the amount requested by the claimant.
February 08, 2022
Judge Denies Disability Claimant’s Motion To Supplement Record

DENVER — A Colorado federal judge on Feb. 7 denied a disability claimant’s motion to supplement the administrative record with documents received after the insurer denied the claimant’s appeal because the claimant failed to meet her burden of proving that supplementing the administrative record is warranted.
January 31, 2022
Editor’s Note

The journalists and staff of Mealey’s Litigation Reports are saddened by the passing of co-founder Michael P. Mealey. He was a respected member of the newsletter community, being named publisher of the year by the National Newsletter Association and president of the National Newsletter Association. Mike and Judy Mealey started Mealey Publications Inc. in 1984. As president, Mike grew the Mealey’s Litigation Report portfolio, introduced email news bulletins and electronic CD formats and launched a continuing legal education conference business. Mealey’s was sold to LexisNexis in 2000. We hope to carry on his journalistic curiosity and integrity in the titles we continue to publish today under his name.
January 28, 2022
District Court Correctly Denied Disability Claimant’s Motion To Amend Complaint

NEW YORK — The Second Circuit U.S. Court of Appeals on Jan. 27 affirmed a district court’s denial of a disability claimant’s motion to amend a complaint to assert a cause of action under the Employee Retirement Income Security Act, agreeing with the lower court’s conclusion that amendment would be futile as the claimant failed to exhaust all administrative remedies prior to filing suit.
January 27, 2022
State Law Claims Are Not Preempted By ERISA; Policy Not Part Of ERISA Plan

TACOMA, Wash. — A disability claimant’s state law claims for breach of contract, breach of the duty of good faith, negligent claims handling and violations of Washington law can proceed because the individual disability income policy at issue is not a plan governed by the Employee Retirement Income Security Act, a Washington federal judge said Jan. 19 in rejecting the insurer’s argument that the state law claims are preempted by ERISA.
January 27, 2022
Disability Claimant Claims Benefits Owed For Long COVID Symptoms

SAN FRANCISCO — A disability claimant suffering from symptoms of long COVID following a battle with COVID-19 asks a California federal court in a Jan. 19 complaint to order a disability insurer to reinstate her short-term disability (STD) benefits and approve her long-term disability (LTD) benefits claim because she remains unable to perform the duties of her own occupation.
January 27, 2022
Disability Claimant Entitled To Award Of More Than $120K For Attorney Fees, Costs

MINNEAPOLIS — A Minnesota federal judge on Jan. 13 granted a disability claimant’s motion for attorney fees and costs and awarded the claimant, who prevailed on her claim seeking long-term disability (LTD) benefits, more than $120,000 in attorney fees and costs after determining that the amount sought by the claimant was reasonable.
January 27, 2022
Disability Plan Did Not Accurately Describe Available Benefits, Judge Says

GREENEVILLE, Tenn. — A Tennessee federal judge on Jan. 24 determined that a plan sponsor breached its fiduciary duty because the employer’s long-term disability plan description did not accurately describe the amount of benefits available to an employee if an employee elected the buy-up coverage for additional benefits.
January 21, 2022
Judge: 3 Of 4 Fraud Elements Of Disability Insurer’s Rescission Claim Pass Muster

FORT MYERS, Fla. — A federal judge in Florida on Jan. 11 substantially granted an insurer’s motion for summary judgment in a lawsuit seeking to rescind a doctor’s disability policy based on material misrepresentations the doctor made in his policy application, ruling that the insurer partially pleaded certain elements of its rescission claim.
January 14, 2022
2nd Circuit Affirms Dismissal Of Claimant’s Disability Suit Under ERISA

NEW YORK — Concluding that there was no clear error in the factual findings and declining to apply a less deferential standard of review, the Second Circuit U.S. Court of Appeals in a Jan. 11 summary order affirmed the judgment of a New York federal court that dismissed a disability claimant’s suit under the Employee Retirement Income Security Act of 1974 following determination on the papers.
January 12, 2022
Policy’s Other Limited Conditions Limitation Properly Applied To Disability Claim

MADISON, Wis. — A disability insurer did not act arbitrarily or capriciously in terminating a claimant’s long-term disability (LTD) benefits because the claimant failed to show that his disability was not subject to the plan’s other limited conditions limitations, a Wisconsin federal magistrate judge said Dec. 27.
January 12, 2022
Bad Faith Claim Against Disability Insurer Cannot Proceed, Judge Says

SAN FRANCISCO — A California federal judge on Dec. 21 granted a disability insurer’s motion for summary judgment on a bad faith claim after determining that there is no evidence showing that the insurer’s investigation was unreasonable and after determining that a question of fact exists as to whether the claimant’s disability was caused by sickness or injury.