We monitor the actions of every disability insurance company nationwide. We constantly report on the latest disability insurance lawsuits, claim handling trends and answer frequently asked questions in order to help disability insurance claimants secure their benefits. Feel free to either leave a comment on any of our articles or privately contact us should you have any questions.
April 27, 2011 —
On March 29th 2011, a lawsuit was filed against the AETNA Life Insurance Company (AETNA Life) at the District court for the Southern District of Florida. In the lawsuit, the plaintiff alleged that AETNA Life had refused to pay the disability benefits sought by the plaintiff under a group long term disability (LTD) benefits policy that was issued and administered by AETNA Life.
The Nature of the Complaint
The plaintiff was a Senior Emergency...
April 25, 2011 —
Routinely, disability insurance companies in their bid to reduce the amount of disability benefits to be awarded to disability benefits claimants will require the claimants to first apply for Social Security Disability benefits. If the claimant happened to be successful in his or her claim for Social Security Disability benefits, the insurance companies will then offset the amount of disability benefits awarded by the amount of disability...
April 22, 2011 —
Here are examples of two recent cases in which SunLife Insurance Company and Aetna Life Insurance Company had a structural conflict of interest and denied disability insurance benefits. In most long term disability insurance claims which are governed by ERISA there is an inherent structural conflict of interest. The conflict of interest exist because the disability insurance company not only pays the benefits, but has the ultimate authority to...
April 21, 2011 —
In any claim for any disability benefits, the deciding factor which disability insurance companies will decide on will be whether you are what they define as being "disabled" or not. Most insurance companies however, will try to define the scope of what constitutes "disabled" as narrowly as possible to their advantage. The situation is especially compounded when a claimant is disabled due to substance abuse. Substance abuse cases involved both...
April 20, 2011 —
A recent Sun Life disability claim by a gunshot victim ended up as a lawsuit in the Orange County Superior Court because of the reluctance of the disability insurance company to pay out any long term benefits to its plan's participants. In Marilyn Ellis v Sun Life Assurance Company of Canada, the plaintiff Marilyn Ellis with her disability attorney contended that she was at all times a participant to a group long term disability plan with the...
April 18, 2011 —
Eric Wilson has brought a lawsuit in the United States District Court of the Eastern District of Louisiana against Reliance Standard Insurance Company and Lincoln National Life Insurance Company because the companies have refused to reply either pro or con to his petition for disability benefits in compliance with his insurance policy contract.
Background of Wilson's Disability Benefits Claim
Reliance and Lincoln National issued an insurance...
April 14, 2011 —
A lawsuit seeking to recover monetary damages from Prudential Insurance Company (Prudential) was recently filed at the Supreme Court of the state of New York. In the lawsuit, the plaintiff Robert Hamil, through his New York disability attorney, alleged that Prudential's termination of his long term disability claim was in violation of his benefit rights that were protected under the Employee Retirement Income Security act of 1974...
April 13, 2011 —
Participating in a disability insurance plan is always an excellent idea as a safeguard against unforeseen circumstances. Nevertheless, we tend to forget that when the time comes for us to try and claim our disability benefits, the disability insurance companies are always extremely reluctant to fork out what is due to us. Quite often, the language that is used in the plan issued by the disability insurance companies contains enough ambiguities...
April 11, 2011 —
A Federal Appellate Court upheld an insurance company's decision to terminate the long-term disability benefits of a woman who suffered from recurrent major depression. Although the woman claimed to now be suffering from Lyme disease, CUNA Mutual discontinued her benefits after two years due to the policy's 24 month mental illness limitation. The Court agreed with CUNA Mutual that there was insufficient evidence to support her claim of...
April 6, 2011 —
A District Court ruling issued in New York's Southern District Court illuminates the importance of understanding the meaning of an "occupation qualifier" and/or an "earnings qualifier" requirement in your long-term disability insurance policy. In general, to qualify for disability under a policy that requires these two prerequisites you must show that:
During the elimination period as well as during the following 24 months that your...
April 1, 2011 —
UNUM Life Insurance Company of America has refused to honor its obligation to provide Scott A. Boles with his disability insurance benefit income even though Mr. Boles qualifies for benefits stipulated in two UNUM Life Insurance Company disability insurance policies. UNUM denied Mr. Bole's disability insurance benefits on both his individual disability policy, on which he has paid all premiums on time and in full since 1994, as well as an...
March 30, 2011 —
An affirming opinion from the Fourth Circuit United States Court of Appeals shows how Administrators of ERISA long term disability benefits can't abuse their power of discretion in North Carolina. This case against LINA also known as CIGNA, is a great victory for claimants suffering from fibromyalgia. In the appeal of Rebecca DuPerry v. Life Insurance Company of North America, Appellee Rebecca DuPerry prevailed in her quest to receive long-term...
March 29, 2011 —
Most long term disability insurance policies allow the insurance company to offset the monthly disability payments to an insured if the insured is receiving "other income" from certain sources. Often, these other sources include any Social Security disability or retirement benefits, workers' compensation benefits, retirement plan benefits from the employer, or even earnings the insured receives from any other occupation or form of employment...
March 28, 2011 —
A federal district court in Pennsylvania recently dismissed Claimant Barry Sunshine's complaint for lack of subject matter jurisdiction. Alleging that Reassure America Life Insurance and Swiss Re Life & Health America, Incorporated prematurely terminated his and other similarly-insured individual's disability insurance benefits, Sunshine and his disability attorneys were attempting to right a wrong for not only Sunshine but for others in a...
March 23, 2011 —
Failing to comply with administrative requirements in a timely manner as specified by Fortis Benefits Insurance Company resulted in Elizabeth A. Bailey being denied benefits from her deceased husband's short-term disability benefits, long-term disability benefits and life insurance policies. Having neglected to follow proper ERISA procedures in pursuing long-term disability and life insurance benefits from Fortis Benefits Insurance Company (a...
March 18, 2011 —
Citing a financial incentive to cheat, the United States Court of Appeals for the Ninth Circuit recently overruled the decision of CIGNA (CI) to deny disability benefits to a man suffering from chronic fatigue syndrome. For anyone disabled by chronic fatigue or fibromyalgia this is a very supportive case and great law. The court provided five reasons that Cigna abused its discretion by denying disability insurance benefits. Let's take a close at...
March 17, 2011 —
After repeated appeals asking CIGNA / LINA to change their decision regarding denial of waiver of life insurance premiums due to total disability, Wendy Magee was recently forced to hire Michigan disability attorneys and file an ERISA disability lawsuit in the Federal Court of the Western District of Michigan.
Ms. Magee worked as a Home Coordinator with the Hope Network. The Hope Network is a non-profit organization that provides specialized...
March 15, 2011 —
An ERISA disability lawsuit was filed against the Liberty Life Assurance Company, this time in Federal Court in the Middle District of Florida. Andrea Medders was forced to file suit after her administrative appeals were denied and Liberty Life, also known as Liberty Mutual refused to pay her long term disability benefits.
In the suit, Ms. Medder's tampa disability attorneys argues that Liberty Life did not afford her with a full and fair...
March 14, 2011 —
Insurer states client should have taken strong anti-psychotic drugs during pregnancy and while breastfeeding, claims she is too "logical" and "organized" to receive benefits.
The Metropolitan Life Insurance Company, known as MetLife (NYSE: MET), is being sued in United States District Court, Southern District of Florida, for refusing to honor its contractual obligation to pay long term disability insurance benefits to a psychologically...
March 9, 2011 —
Disability Attorneys Dell & Schaefer filed a disability insurance lawsuit against The Guardian Life Insurance Company of America in a New Jersey Federal court. The lawsuit involves a New Jersey OB/GYN's claim for long term disability benefits following injuries he suffered in a car accident.
According to the disability lawyers involved with the lawsuit, Guardian Life Insurance paid the doctor for approximately two years prior to...
March 9, 2011 —
A Federal lawsuit filed in United States District Court Southern District of Florida accuses the Hartford Life and Accident Insurance Company of breaching its contract with Branch Banking and Trust (BB&T) and a BB&T employee. Filed by noted disability insurance law firm Dell and Schafer, the suit states that Hartford is refusing to pay benefits to the employee, a U.S. Patriot Act/Anti-Money Laundering Analyst. The refusal by The Hartford...
March 8, 2011 —
Disability Insurance Attorneys Dell and Schaefer filed a Federal Lawsuit against Life Insurance Company of North America (LINA), which is part of CIGNA Corp (CI.N). The lawsuit was filed after Cigna refused to pay disability benefits to a Florida teacher forced to stop working due to mental health issues such as depression, bipolar disorder and schizophrenia.
According to the disability lawsuit, filed in the Middle District of Florida...
March 7, 2011 —
The United States Court of Appeals for the Ninth Circuit recently ordered a lower court to reconsider its decision that had affirmed Hartford Financial Insurance Company's denial of a woman's claim for disability benefits. Although the claimant has not yet been awarded her requested disability benefits, the Appeals Court's decision leaves her one step closer to achieving this goal.
The Appeals Court remanded the case of Janice Parker back to...
March 2, 2011 —
A recent opinion from the United States District Court in the Eastern District of Michigan shows how difficult it can be get a court to award disability benefits instead of just remanding a wrongful termination decision back to the plan administrator. Although the Court in this action remanded the case back to the plan administrator for a new review, it did award the claimant's Michigan disability attorney partial attorney's fees. To understand...
February 28, 2011 —
A Federal District Court in Pennsylvania recently dismissed the case of a long-term disability claimant who claimed damages resulting from Prudential Insurance Company's delay in the approval of her claim for long-term disability insurance benefits. Although the claimant was eventually awarded disability benefits by Prudential Insurance Company, she still filed a lawsuit for the damages she allegedly suffered due to the carrier's delay in...
February 23, 2011 —
A federal district court in California recently ruled that a disability claimant could not recover on his state-law claim for breach of implied covenant of good faith and fair dealing. This specific count is also known as "Bad Faith". The court found that the disability plan at issue fell under the federal ERISA statute, and, as such, his state-law claim was preempted by ERISA. ERISA prohibits bad faith claims, which is why every insurer always...
February 22, 2011 —
According to the American Heart Association, one out of three, or approximately 81 million Americans have heart disease. In 1963 Congress proclaimed February as "American Heart Month" in order to raise awareness and fight the battle against heart disease. Millions of Americans each year are unable to work as a result of heart disease and are forced to file for either disability insurance benefits or social security disability benefits. Heart...
February 21, 2011 —
A Federal District Court in New York recently dismissed the class action lawsuit of four individuals whose disability insurance claims were denied or terminated by the Unum Provident Corporation. The individuals filed the lawsuit because they believed that Unum denied or terminated their claims to meet expectations as to revenue and profit for the corporation. To understand the Court's decision, we must look at the underlying facts of the case...
February 18, 2011 —
It isn't always the claimant who appeals a District Court decision. The District Court may rule in favor of the claimant and have its decision challenged by the disability insurance provider. Wenner v. Sun Life Assurance Company of Canada is just such a case. Arguments were heard in the U.S. Court of Appeals, Sixth Circuit, located in Cincinnati, Ohio. The case arose from Nashville, Tennessee. This entire disability claim could probably been...
February 16, 2011 —
An interesting disability claim arose in 2008 that highlights the challenges a disabled individual can face when a span of time exists between the time of a covered event and the manifestation of an injury associated with that event. This case against CIGNA is rare because it is an accident and sickness policy rather than a traditional disability insurance policy. It is also rare, because most disability insurance companies will not lose a copy...