Mealey's Disability Insurance
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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October 06, 2022
Judge: Overwhelming Medical Evidence Supports Finding That Claimant Is Disabled
SANTA ANA, Calif. — A disability insurer abused its discretion in denying a claim for long-term disability (LTD) benefits because the medical evidence overwhelmingly supports a finding that the claimant is unable to perform the duties of her own occupation, a California federal judge said in granting judgment in favor of the disability claimant.
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October 06, 2022
Termination Of Disability Benefits Not Abuse Of Discretion, Judge Says
PITTSBURGH — A disability plan’s termination of a claimant’s long-term disability (LTD) benefits was not an abuse of discretion because the plan’s finding that the claimant was not disabled from performing the duties of any occupation is supported by substantial medical evidence.
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October 05, 2022
Disability Claimant Entitled To Benefits For Post-Traumatic Stress Disorder
SEATTLE — A disability claimant who suffered from symptoms of post-traumatic stress disorder (PTSD) after being sexually harassed by an executive at the bank where she worked was disabled from performing the duties of her own occupation as a bank manager because the medical evidence shows that the claimant was consistently disabled from working even after she stopped working as a bank manager, a Washington federal judge said.
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October 05, 2022
Breach Of Fiduciary Duty Claim Dismissed; Disability Claimant Has Adequate Remedy
ATLANTA — A Georgia federal judge granted a disability insurer’s motion to dismiss a breach of fiduciary duty claim after determining that the claimant has an adequate remedy under the law through her claim seeking a declaration that benefits are owed under the Employee Retirement Income Security Act.
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October 04, 2022
Termination Of STD Benefits Not Arbitrary, Capricious, 6th Circuit Panel Says
CINCINNATI — A district court did not err in finding that the termination of short-term disability (STD) benefits was not arbitrary and capricious based on the medical evidence included in the administrative record, the Sixth Circuit U.S. Court of Appeals said in affirming the decision entered in favor of the STD plan.
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October 03, 2022
High Court Denies Claimant’s Petition, Refuses To Review Disability Benefits Suit
WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 3 denied a disability claimant’s petition for writ of certiorari in a suit alleging that a settlement between the claimant and disability insurer should not be enforced.
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September 29, 2022
Breach Of Contract, Bad Faith Claims Preempted By ERISA, Judge Says
BOSTON — Remand of a disability claimant’s suit seeking to recover disability benefits is not warranted because the state law claims, alleged by the claimant, are preempted by the Employee Retirement Income Security Act, a Massachusetts federal judge said in denying the claimant’s motion to remand.