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.
August 24, 2017 —
In Rouleau v. Liberty Life Assurance Company of Boston, plaintiff Michelle Rouleau, a Registered Nurse (RN) for a Hospital, had a history of intractable lower back pain dating back many years. As an employee of the Hospital, she was covered by a Group Long-Term Disability Insurance policy issued by Liberty Life (Liberty).
Under the terms of the LTD Policy, the definition of disability changed after benefits were paid...
August 7, 2017 —
In Cathleen Kennedy v. The Lilly Extended Disability Plan, plaintiff Cathleen Kennedy, an executive Director of Human Resources, had a history fibromyalgia dating back many years. As an employee of Eli Lilly and Company, she was covered by The Lilly Extended Disability Plan (“the Plan”), which was administered initially by Anthem Life and Disability and later by Sedgwick Claims Management Services (“Sedgwick”).
July 27, 2017 —
MetLife Inc., the New York-based insurer that traces its roots to the 1860s, has come up with a new name for a U.S. retail unit that’s slated for separation. The business will be known as Brighthouse Financial once it’s broken off from the parent company.
The insurer is seeking to give a fresh identity to the U.S. operation that offers annuities and life policies such as disability insurance and life insurance policies to individuals. As...
July 18, 2017 —
In Jarillo v. Reliance Standard Life Ins. Co., Judge Michael M. Anello of the United States District Court of the Southern District of California held that plaintiff Marife Jarillo met her burden of proof and was entitled to benefits under the ERISA. For about eight years, Jarillo worked in the marketing department of the Sycuan Band of The Kumeyaay Nation (a federally recognized Native American tribe located near San Diego). In 2010, Jarillo...
June 29, 2017 —
In Jane Doe v. Standard Insurance Company, plaintiff Doe spent more than 25 years as an environmental attorney for a Maine law firm prior to become ill with depression and anxiety. She filed a claim for mental health disability benefits under the law firm’s disability policy. Her claim was approved, but based on a disability date of January 2012, when she claimed the date should be October 2011. Standard also awarded benefits based on the...
June 20, 2017 —
When it comes to claims for short term disability benefits under ERISA governed group policies, more often than not the short term disability policy is not underwritten by an insurance company, but rather it is administered by an insurance company. What this means is when a policy is underwritten by an insurance company the insurance company financially funds the disability benefit to be paid from its own assets; and in situations where an...
June 15, 2017 —
Our office was recently contacted by an insured whose claim for long term disability benefits had been recently and abruptly denied by Prudential based on allegations of insurance fraud stemming from answers provided in an Activities of Daily Living Questionnaire (ADLQ) form and a subsequent field interview. For anyone on claim with Prudential, or with any disability insurance company for that matter, the ADLQ form is a very common claim form...
May 30, 2017 —
The case of Kidd v. The Prudential Insurance Company of America demonstrates the importance of disclosing all potential assets on a bankruptcy petition. This includes an administrative claim for long-term benefits and potential for a lawsuit if those benefits are denied. Because of the plaintiff’s claim she had no assets in Bankruptcy Court, she was judicially estopped from pursing her ERISA lawsuit in the Texas federal District Court, since...
May 24, 2017 —
In Anderson-Posey v. Unum Life Insurance Company of America, plaintiff Traselynn Anderson-Posey, a CVS pharmacist, tripped, fell and injured her coccyx. The next day, June 21, 2013, she visited her primary care doctor, Dr. Hunter. Plaintiff complained of severe pain and an inability to sit down. Hunter prescribed narcotics and, when an x-ray showed a fracture, Hunter referred Plaintiff to Dr. White, a pain management specialist.
May 11, 2017 —
The case of Arturo J. Otero v. Unum Life Insurance Company of America has an extensive procedural history going back to 2005 when Otero first applied for disability benefits due to his atrial fibrillation. He had a contentious bout with Unum at that time and returned to work on a part-time-basis in 2010. He continued to pay premiums to Unum for disability coverage.
In February 2013, Otero filed a new claim for long-term disability. His atrial...
April 27, 2017 —
In the recent decision of Tobin v Hartford Life & Acc. Ins. Co. a Michigan Federal District Court overturned Hartford’s denial of long term disability benefits to a former Disney employee suffering from Fibromyalgia. The Court noted in its opinion that Hartford’s requirement of objective evidence of the diagnosis of Fibromyalgia was arbitrary under applicable case law in Michigan and that in denying her claim for benefits Hartford failed to...
March 28, 2017 —
In Chamness v. Liberty Life Assurance Company of Boston, plaintiff James Chamness, a board-certified pediatrician who is also a pediatric sleep specialist, applied for long term disability benefits. He claimed he suffered from both physical and mental disorders. Specifically, he was diagnosed with asthma, irritable bowel syndrome, coronary artery disease, sleep apnea and gastroesophageal reflux disease.
Plaintiff was also diagnosed with...
March 22, 2017 —
Long-term disability attorneys Cesar Gavidia and Gregory Dell discuss a recent case against Prudential Insurance Company in which long term disability benefits were denied because the claimant claimed LTD benefits after he was terminated by his employer. This is a very specific fact pattern in this case, but it worked out well for the claimant. People seeking disability must always be careful if they are terminated prior to stopping work, then...
March 21, 2017 —
Thousands of long term disability claimants receive both social security disability benefits and long term disability benefits. In this recent video we discuss a great legal decision in which Liberty Mutual's long term disability benefit denial was reversed for failure to properly consider the SSDI benefit approval.
A disability carrier is not bound by the SSDI approval, must they must consider it and give a reasonable basis for disagreeing...
March 15, 2017 —
The Six Circuit Court of Appeals reverses a Hartford long term disability benefit denial.
Long term disability insurance attorneys Stephen Jessup and Gregory Dell discuss this recent case in which the court basically states that there is no objective evidence of Fibromyalgia. It seems that the courts are really starting to understand fibromyalgia and its devastating effects on a person’s ability to work.
We hope you find this video...
March 9, 2017 —
Disability insurance claimants naively believe that managing their own disability claim is a simple process. There are disadvantages of managing your disability insurance matter, especially when filing your own appeal. The goal of an appeal is to overturn the insurance companies decision and to strengthen your case if you have to file a lawsuit.
With an ERISA governed policy an appeal is filed because your initial claim has been...
February 27, 2017 —
Attorneys Dell & Schaefer is skilled at negotiating Aetna lump sum buyouts. Typically, Aetna doesn’t offer a buyout option, but it is not impossible to get the highest dollar offer from Aetna. You need to know the pros and cons of a buyout, and most of all you need to understand the settlement and release agreement - especially if you choose to return to work. Attorneys Dell & Schaefer will always negotiate the highest buyout settlement and...
February 24, 2017 —
In Armani v. Northwest Mutual, plaintiff Avery Armani, a Controller for an insurance agency, injured his back while lifting a heavy back-up power supply at work. As an employee of the insurance agency, he was covered by a Group Long-Term Disability Insurance policy issued by Northwest Mutual (NWM).
Under the terms of the LTD Policy, the definition of disability changed after benefits were paid for 24 months. For the...
February 17, 2017 —
In December 2016, the U.S. Department of Labor issued its Final Rule for new regulations applicable to the way in which employers administer their employees’ claims for disability under the Employment Retirement Income Security Act (ERISA). The changes went into effect on January 1, 2017, but in order to give employers time to make the required adjustments to their claims processing procedures, the new rules will apply only to claims submitted...
February 3, 2017 —
President Donald Trump nominated Neil Gorsuch to the Supreme Court on Tuesday. At 49, Gorsuch is the youngest Supreme Court nominee in a quarter-century. Trump's choice of Gorsuch marks perhaps the most significant decision of his young presidency, one with ramifications that could last long after he leaves office. Read the article here.
January 11, 2017 —
It is without question that we live in a world that is often driven by social media. For a multitude of reasons people are becoming increasingly more willing to make what used to be private facets of their lives open to the public. Often the information being shared projects an image of what we want people to see as opposed to the burdens and hardships just below the surface. With the prevalence of social media this scenario can have disastrous...
January 5, 2017 —
In Bosley v. Metropolitan Life Insurance Company (MetLife), plaintiff Robert Bosley, a registered nurse, has his 2009 claim for long term disability approved by MetLife. He received benefits from 2008 until 2010 at which time he returned to work in sedentary “desk job” position. In 2011, he again received long term disability benefits running from 2011 until 2012 when he returned to work as an advice nurse at a call center.
December 27, 2016 —
In Brasseur v. Life Insurance Company of America (LINA), Plaintiff Wilfred Brasseur, a computer engineer, worked in the Houston office of Chicago Bridge & Iron Company when he became disabled. LINA denied his application for long term disability benefits on the grounds that he “was not disabled as defined by the Plan’s terms.” Ultimately, Brasseur filed an ERISA lawsuit in Houston. He filed a motion for summary judgment limited to the...
December 21, 2016 —
In Filthout v. AT&T Midwest Disability Benefit, et al., plaintiff Rebecca Filthout had worked several years for Michigan Bell Telephone Company as a service representative when she began having chest and back pain. She was initially diagnosed with kidney problems. Her first application for short term benefits under her employee disability insurance policy provided by AT&T Midwest Disability Benefit Plan (AT&T) was granted and she took about a...
December 13, 2016 —
Michelle Duncan worked for 22 years for Verizon. She started with the company upon her graduation from high school back when Verizon was known as U.S. West Paging. She worked her way up the ladder to the position of Global Enterprise Manager. It was a high-pressured job requiring travel and dealing with hundreds of email communications every day.
In 2010, she began having auditory hallucinations. She suffered from feelings...
December 6, 2016 —
In Carr v. John Hancock Life Insurance Co., plaintiff David Carr, a former Shell employee, suffered from a number of illnesses including anxiety, hypertension and prostate cancer. Additionally, he was legally blind. While employed at Shell, he was covered by a Group Long-Term Care Insurance policy.
According to the written terms of the policy, Carr was eligible for benefits if, due to “a loss of functional...
November 29, 2016 —
In Owens v. Metropolitan Life Insurance, Judge Richard Story of the Northern District of Georgia Federal Court found that MetLife breached its duty to Laura Owens and similar beneficiaries. In April of 2012, Robert Owens died, leaving Laura a widow. Through his employer, Robert had life insurance from MetLife.
MetLife approved Laura Owen’s life insurance claim and established a “Total Control Account” (TCA) in Owen’s name. Under this...
November 25, 2016 —
In Hutchings v. Lora Lyons, Plan Administrator, and Ball Industries Employee Injury Benefit Plan, et al. (Defendants), plaintiff Linda Hutchings injured her knee while at work. Her initial request for disability benefits was granted so she could have surgery for a torn right medial meniscus. The surgery was not successful.
Just a few months later, she requested disability benefits so she could have a total knee replacement surgery and her...
November 22, 2016 —
In Brown v. United of Omaha Life Insurance, United unsuccessfully tried to avoid paying a death benefit to Lloyd Brown III, the beneficiary of a life insurance policy chosen by his father, Lloyd Brown II. Ultimately, Brown III won, but the case was remanded to the district court to determine the exact monetary amount of his award as well as the amount of attorney’s fees and prejudgment interested to which Brown III was also entitled.
November 17, 2016 —
Nationwide disability insurance attorneys Rachel alters and Cesar Gavidia discuss the importance of getting treatment from a specialist for your disability. Disability insurance claimants receiving benefits know the importance of regular doctor’s visits. However, did you know that disability insurance companies will discontinue benefits if you are not being seen by a specialist? That’s right, if you are not receiving treatment from a...