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.
November 8, 2016 —
In Fessendon v. Reliance Standard Life Insurance Company, plaintiff’s claim for long term disability benefits under an ERISA governed plan was denied. There is a dispute between the parties as to whether the court should apply an abuse of discretion standard or a de novo review. Plaintiff filed a motion arguing that the court should review his ERISA claim de novo since Reliance did not issue its denial of his claim within the time required...
October 31, 2016 —
Hartford is requesting long term disability claimants to provide additional documentation from their attending physicians and additional claimant statements more often than usual. Additional documentation is typically requested as a claimant nears 24 months of payments and there is a change in the definition from the own occupation to the any occupation. In this video, attorney Gregory Dell discusses the reasons why a disability insurance...
October 31, 2016 —
Attorneys Dell & Schaefer is not your typical law firm. We always work extremely hard, but Halloween is a day for us to take a few hours to play hard. Each year we have an annual Halloween employee costume contest, pie-eating contest, and dessert cooking competition on the Friday before Halloween. Most of our staff and lawyers dress up and compete for the Best Costume title! This year we put together a short video of our Halloween Contest and...
October 27, 2016 —
Patti Okuno was an art director with a clothing company when she developed a number of various symptoms, including extreme headaches, abdominal problems, vertigo and memory loss. She was diagnosed with narcolepsy, Crohn’s disease and Sjogren’s syndrome. Her medical records indicated that she also suffered with anxiety and depression.
Reliance Standard Life Insurance Company (Reliance), both the payer of benefits and plan administrator...
October 25, 2016 —
In Reed v. Citicorp and Metropolitan Life Insurance Company of America, the Third Circuit appellate court did not rule on the merits of plaintiff Frank Reed’s claim that MetLife, Plan Administrator for Citigroup, erred in terminating his long term disability benefits. However, the court did find that the New Jersey District Court erred in granting MetLife’s summary judgment on two major issues raised by Reed. It remanded to the District...
October 20, 2016 —
Every day our law firm is contacted by at least 10 people that were initially approved for long term disability insurance benefits and now the insurance company has notified them that after several years of paying benefits the claimant is no longer disabled. Despite reviewing thousands of these disability insurance claim denial letters throughout my career I still feel amazing frustration and anger when I read 90% of these denial letters. It is...
October 11, 2016 —
In Webb v. Liberty Life Assurance Company of Boston, Ronald Webb, an employee of Adobe Systems Incorporated, took out several life insurance policies:
· A basic life insurance policy for $250,000.
· An optional life insurance policy for $1 million.
· A basic accidental death insurance policy for $250,000.
· An optional accidental death insurance policy for $1 million.
The policies went into effect on May 11, 2012. On December 27...
September 28, 2016 —
In Aberg v. Charter Communications, Inc., et. al, plaintiff fell off her horse on two separate occasions. She was seriously injured in the first fall, suffering a compression fracture of her vertebrae among other injuries. Barely a year after the first fall, she was “thrown off” of her horse again. Her treating physician and physical therapist both recorded in their records that the second fall significantly exacerbated her previous...
September 22, 2016 —
Cheney v. Standard Insurance Company and Long Term Disability Insurance (Standard) is a case in which the U.S. Court of Appeals for the Seventh Circuit sent back to the Illinois District Court for resolution of several issues. One issue concerned whether or not the plaintiff was disabled from working within her own occupation.
Overview of Relevant Facts
In 1991, the plaintiff, Carole Cheney, began working as an attorney for Kirkland &...
September 7, 2016 —
In Bunger v. Unum Life Insurance Company of America, the plaintiff was a Web Content specialist for Costco when he became ill and unable to work. His treating physician diagnosed him with Lyme disease and he received short term disability benefits for a period of time. He had numerous visits with his treating physician who also diagnosed him with chronic fatigue syndrome. He suffered from a multitude of symptoms, which were noted in his medical...
August 30, 2016 —
In Tash v. Metropolitan Life Insurance Company (MetLife), Raymond Tash, a dentist, became disabled due to multiple injuries and was initially granted disability benefits when he could no longer work in his own occupation. After one year, MetLife discontinued its payment even though the policy provided for 24 months of benefits, so the dentist filed an ERISA lawsuit. That lawsuit was settled. MetLife paid Tash a sum of money and agreed to...
August 26, 2016 —
Thornton v. Sedgwick is a fact-driven case in which a California district court ruled that Sedgwick “incorrectly determined in January 2014 that [plaintiff] was no longer eligible for disability benefits.” The plaintiff, Catherine Thornton, was a project manager for Southern California Edison (SCE) when she developed bilateral carpel tunnel syndrome, bilateral cubital tunnel syndrome and epicondylitis. She underwent surgery on both arms...
August 8, 2016 —
In Curtis v. Metropolitan Life Insurance Company, a Texas District court focused only on the standard of review it will use when it evaluates MetLife's denial of plaintiff’s long term disability benefits. Three issues were raised: 1) Did MetLife’s plan contain a discretionary clause; 2) Was the clause banned under Texas law applicable to insurance policies; and, 3) Was the Texas law banning the clause preempted by ERISA.
In 1989, the...
July 26, 2016 —
Dowdy v. Metropolitan Life Insurance Company (MetLife) is a sad case for plaintiffs who have a pre-existing condition that contributes to their otherwise qualifying event for collecting insurance benefits. Thomas Dowdy and his wife had purchased an accidental death and dismemberment policy through Mrs. Dowdy's employment at Bank of the West.
Plaintiff Thomas Dowdy was in a one-car accident in which he suffered numerous severe injuries. His...
July 19, 2016 —
In Dunda v. Aetna, Aetna terminated plaintiff's long term disability benefits even though there was no medical evidence that her disabling conditions had improved since it granted her long term disability benefits. The plaintiff, a former general store manager for the Wawa corporation, suffered from a number of conditions which caused her debilitating low back pain: lumbar herniated nucleus pulposus, a herniated disk and sciatica. She was...
July 12, 2016 —
A recent study by the Centers for Disease Control and Prevention has discovered that ticks that spread Lyme disease now live in almost half of U.S. counties. However, the risk of people contacting Lyme disease is not equal across areas of the United States. The blacklegged ticks may carry the bacteria Ixodes scapularis, also known as deer ticks, and the western blacklegged tick, Ixodes pacificus. These ticks are typically found in wooded and...
July 7, 2016 —
In Wilson v. Provident Life and Accident Insurance Company, Woodrow K. Wilson, a shareholder of the Woodrow Wilson Construction Company, Inc., purchased an individual disability insurance policy from Provident in 1993. On April 18, 2013, for the first time, Wilson filed a claim for disability stating he had been unable to work since October 13, 2008, due to osteoarthritis pain in his shoulder, left knee and low back. Provident denied his claim...
June 22, 2016 —
In McKenna v. Hartford Life & Accident Insurance Co., the Minnesota federal court remanded to the Hartford plan administrator for reconsideration of its termination of McKenna's long term disability benefits. The court held that since Hartford failed to inform McKenna, who was representing herself, of "what type of objective evidence she needed to provide with her appeal," and she did not understand that a functional capacity evaluation (FCE)...
June 14, 2016 —
In Coulter v. Aetna Life Insurance Company, a Michigan federal court found that Aetna committed a number of errors in its review of claimant Sharon Coulter's medical file. In addition, it misinterpreted three separate Functional Capacity Evaluations (FCE). The Benefit Appeals Committee (BAC) for Alcoa, Coulter’s employer, relied on the information provided to it by Aetna to terminate Coulter's long term disability benefits.
May 26, 2016 —
In Peterson v. Principal Financial Group, plaintiff injured her back in a car accident and subsequently underwent a spinal fusion. She was awarded 24 months of disability when she was unable to return to her own occupation as a Target employee. After 24 months, the definition of disability changed to requiring her to be disabled from any job "that provides 128% or more of the disability benefit." Principal refers to these as "extended...
May 18, 2016 —
In Bigham v. Life Assurance Company of Boston, a Seattle federal court held that Liberty erred in terminating the plaintiff's long term disability benefits when it was clear that she could not perform the required tasks of her own occupation as a Security Technical Program Manager for Amazon, LLC. In that role, she was required to "focus her thoughts and interact with others for long periods of time on a daily basis." Three treating physicians...
May 11, 2016 —
In Winkler v. Principal Life Insurance Company, Thomas Winkler, a financial planner, collected 24 months of disability benefits when he was unable to work in his own occupation due to his neuromyelitis optica, also known as Devic's Syndrome. At the time he became disabled, he was covered by a policy that was later amended to provide a wider, more encompassing, definition of disability. Winkler argued that, in addition to his benefits being...
April 29, 2016 —
In Green v. Sun Life Assurance Co., the issue concerned whether or not the claimant was continuously disabled during the 180-day required elimination period in order to qualify for disability benefits. The plan administrator, Sun Life Assurance Co., was aware that the claimant had been awarded disability benefits by the Social Security Administration (SSA), but failed to review the SSA file or the determination of the Administrative Law Judge...
April 26, 2016 —
In Zorn v. Principal Life Insurance Company, the plaintiff, a member of the National Association of Professional Insurance Agents, obtained insurance provided to the association by Principal Life Insurance Company (PLIC). The policy provided for five years of benefits for those disabled from their own occupation. After that time, the definition of disability changed and insureds were then considered disabled only if they could not perform the...
April 25, 2016 —
Shuping v. The Union Central Life Insurance Company is a plaintiff friendly case in the early stages of disability litigation in a Texas federal court. After Randy Shuping filed his ERISA lawsuit, Union Central made a motion asking the court to make its disability decision solely on the administrative record. It argued that plaintiff was not entitled to discovery of any other information or documents. Shuping filed a detailed motion explaining...
April 21, 2016 —
In Spath v. Standard Insurance Company, the plaintiff was injured at work and was initially granted disability benefits. Upon a review of the claimant's file, Standard changed its mind. On September 17, 2014, Standard sent Spath a letter telling her it had made a mistake and was immediately terminating her benefits. The letter told her she had 180 days to file an appeal and, if she did not, it would close her file.
Spath did not appeal...
April 20, 2016 —
In Halley v. Aetna Life Ins. Co., the plaintiff, an executive vice-president of a manufacturing company, suffered from spinal osteoarthritis and underwent numerous surgeries including a spinal fusion. He was granted three years of disability benefits when he was unable to perform the job requirements of his own occupation.
After 36 months of disability, the definition under the Aetna policy changed, allowing benefits only if the claimant was...
April 13, 2016 —
In Zuke v. American Airlines, Inc., plaintiff had received 13 years of long term disability benefits when MetLife, the plan administrator, terminated them. When Zuke's administrative appeal was denied, she filed an ERISA lawsuit. When the Ohio district court agreed with MetLife, she appealed. On appeal, the Sixth Circuit held that MetLife's termination of benefits was arbitrary and capricious since it was based on reviewing doctors' opinions...
March 29, 2016 —
In McMillan v. AT&T Umbrella Benefit Plan No. 1, the plaintiff, who had worked for AT&T for nearly six years as a Senior IT Client Consultant, filed a claim for short term disability benefits based on multiple medical conditions, including his coronary disease, hypertension, diabetes and sleep apnea. The plan administrator for AT&T is Sedgwick Claims Managements Services, Inc. (Sedgwick).
Although his job duties required detailed cognitive...
March 24, 2016 —
In Sim v. Reliance Standard Insurance Co., et al, the Sixth Circuit court in Ohio granted plaintiff's motion for discovery in his quest to show that Reliance did not give his claim for disability benefits a full and fair review due to its conflict of interest between being the plan administrator and the payor of benefits. In granting plaintiff's motion, the court relied on other Sixth Circuit cases and noted that, "The court need not decide...