Disability Insurance Lawsuit Stories
Disability denial lawsuit decisions from courts nationwide, reviewed by our attorneys. Learn how policyholders fought back against wrongful claim denials and won.
Showing 221–240 of 766 Lawsuit Stories
Mechanic Loses Claim For Benefits Against Reliance Standard After Employer Makes Oral Misrepresentations Concerning Disability Insurance Coverage
Generally, when employees have a question concerning their employer provided group long-term disability insurance coverage, the first place they turn is to their HR department. HR Departments are not in the business of underwriting, or interpreting insurance policies, and often do not have the adequate knowledge to competently answer specific questions concerning the terms and conditions of the disability insu...
California Federal Court Finds Man Disabled, Overturns Unum's Decision that denied Long Term Disability Benefits
A former Assistant Sales Manager for HSBC was forced to leave work on May 14, 2008. This claimant suffered from constant low back pain due to spinal stenosis, disc bulges and protrusions, spondylosis at the L3-L4 and L4-L5 interspaces with T2 signal loss in the discs and disc space narrowing. The claimant described his constant pain like "the point of a bayonet into his back" that was "made worse by prolonged ...
Is Cigna's Medical Director John M. Mendez Licensed to practice medicine?
During the pendency of an ERISA disability administrative appeal with Cigna disability insurance company our disability lawyers requested the resume of the in-house medical doctor at Cigna. The resume was requested in order to verify the qualifications and experience of the physician that was hired by Cigna. After more than 30 days of waiting for a response, Cigna provided an extremely generic resume for Dr. J...
Court Finds Objective Evidence Alone, Without Supporting Subjective Evidence, Is Not Enough To Prove Disability, Rules in Favor of Hartford
We typically see cases where claimants provide the disability insurance company with medical records that reflect substantial subjective complaints, such as pain, fatigue, headaches, but lack objective evidence - positive findings on MRIs, X-rays or lab work. The disability insurance companies commonly deny claims on the basis of there being no objective evidence.However, a recent case out of Connecticut w...
A Letter to Cigna CEO Following Denial of Disability Benefits to a Wheel Chair Bound Woman
It is not often that we send a letter to the President / CEO of a disability insurance company, but the conduct of Life Insurance Company of North America / CIGNA by denying disability insurance benefits to our client required us to do so. We hope Cigna will respond, but despite a $77 million dollar regulatory Settlement in May 2013, Cigna continues to engage in their same unreasonable claim denials.Below ...
MetLife Improperly Applies Limitation For "Neuromusculoskeletal and Soft Tissue Disorder" to Long Term Disability Claim
MetLife writes one of the most restrictive 24 month limitations in its ERISA governed group disability policies for medical conditions that they deem fall under the definition of "Neuromusculoskeletal and Soft Tissue Disorder." The language commonly used defines the term to mean:Neuromusculoskeletal and soft tissue disorder including, but not limited to, any disease or disorder of the spine or extremities...
United of Omaha Life Insurance Co. Denial of Long Term Disability Benefits Reversed By Alabama Judge
A recent disability insurance court decision against United of Omaha Life Insurance Company, and affiliate of Mutual Of Omaha Insurance Company is a great victory for claimants suffering with either fibromyalgia or rheumatoid arthritis. The Alabama Federal Judge states in her 39 page written opinion that it was abuse of discretion for United of Omaha to deny disability benefits during the any occupation stage ...
Court grants partial summary judgment in favor of Plaintiff, remanding claim back to Aetna to review records it failed to review during the appeals process
In the case of Cannon v. Aetna Life Insurance Company, a Massachusetts Court found that Aetna abused its discretion in denying LTD benefits to a pharmacist with Lyme Disease. The Plaintiff argued that Aetna failed to provide specific documents during the administrative appeal process, such as the entire claim file, which calls into question the integrity of Aetna's decision to deny his benefits.Why is Aetn...
Lawsuit Against IME Physician Alleging Fraudulent Misrepresentation By IME Physician Dismissed by US District Court
Prior to her disability, Angel Dix was employed with Blue Cross / Blue Shield of Louisiana and insured under the company's long-term disability insurance plan. After enduring years of chronic back pain resulting from degenerative disc disease, and having undergone multiple spinal cord surgeries with no resolution of her chronic back pain, Mrs. Dix was forced to stop working and file a claim for disability bene...
Anesthesiologist Loses Disability Insurance Lawsuit Against Sun Life Assurance Company in Pennsylvania Federal Court
On September 16, 2013, a Pennsylvania Federal Judge ruled that Sun Life Assurance Company was correct in denying long term disability insurance benefits to an Anesthesiologist claiming disability due to headaches and abnormal finding on Brain MRI. No portion of this disability claim was handled by Dell Disability Lawyers. The doctor in this case claimed that he was disabled as of December 11, 2007 when he resi...
Attorney sues Unum to recover benefits after Unum terminates disability claim after learning attorney committed fraud; Unum counterclaims for over $1 million in overpaid benefits
Attorney claims disability due to back, leg and foot pain, receives disability benefits for three years until Unum terminates based on surveillance video, IMEs and an FCE. On appeal Unum reinstates benefits until notified by scorned boyfriend that she was committing fraud. Unum again terminates benefits claiming fraud and requests repayment for over $1 million in overpaid benefits.In the Fifth Circuit case...
Insured's Lawsuit Dismissed By Massachusetts Federal Court For Being Filed Too Late
On September 11, 2013, a Massachusetts Federal Judge ruled that a long term disability insurance claimant whose monthly benefit had been underpaid by MetLife since 2005 was not able to collect the money owed as he waited too long to bring a lawsuit. No portion of this disability claim was handled by Dell Disability Lawyers.The plaintiff in this case argued that each month that MetLife underpaid his monthly...
US Supreme Court to Hear Disability Insurance Case Against Hartford Insurance Company
On October 15, 2013, the United States Supreme Court will hear oral argument in a long term disability insurance case against Hartford Insurance Company (Heimeshoff v. Hartford Life & Accident Insurance Co.). The issue before the court involves a long term disability insurance lawsuit which was dismissed as a result of the claimant filing a lawsuit after the statute of limitations had run. The claimant was...
California Court holds that Hartford Abused Its Discretion in Denying Amazon.com employee LTD Benefits
Claimants become frustrated and feel helpless when their disability benefits are cut off by their insurance company with the explanation that they no longer meet the definition of disability when their own treating physicians documented that they were totally disabled and unable to work in even a sedentary occupation. It has become common practice for insurance companies to deny claims based on opinions from p...
Pennsylvania Court Awards Long Term Disability Benefits To Claimant, Finds Aetna Abused Discretion By Failing To Consider Self-Reported Symptoms
The claimant in this case, Ms. K, went on short term disability leave after developing anxiety and fatigue upon returning from maternity leave. She received treatment from her psychiatrist and eventually returned to work. When she returned to work, she was informed that she was required to increase her work week from 25 hours to 40 hours. Immediately thereafter, she suffered an increase of panic and resumed he...
Credibility Judgments Without IME Lead to Remand Back to Libery Life for Full and Fair Review in Kentucky ERISA Disability Lawsuit
Background and History of the ClaimThe Plaintiff in this case, Ms. L, applied for Waiver of Premium benefits with her Plan's administrator, Liberty Life Assurance Company of Boston, also known as Liberty Mutual. She claimed disability due to her medical conditions of insulin-dependent diabetes mellitus type II, chronic pain, degenerative joint disease, degenerative disc disease, myofascial pain syndrome, m...
Missouri Court Awards Full Disability Benefits in Mental Nervous Condition Case Against Hartford
This ERISA lawsuit filed in Missouri Federal Court against Hartford is a textbook-like example of how Hartford will go to great lengths to ignore clear-cut medical evidence, including standing behind knowingly faulty and questionable reports from their paid physician file reviewers, as a means to justify denying claims of those who are truly disabled and entitled to benefits under the terms of their Long Term ...
New York Court Recognizes Unum Insurance Company's History of Biased Claims Administration and Permits Discovery Into a Potential Conflict of Interest
One important aspect of ERISA cases that makes them different from other types of lawsuits and litigation, is that once the administrative appeal process closes and an ERISA lawsuit is filed, the "administrative record" can no longer be added to, or supplemented. This is because in an ERISA matter, the judge is only allowed to consider the evidence that was available to the claims administrator at the time the...
New York Judge's 168 Page Ruling Finds In Favor Of Hartford's LTD Benefit Denial In ERISA Lawsuit
The ERISA long term disability lawsuit filed against Hartford did not raise any issues out of the ordinary. The Plaintiff sought reversal of the decision to terminate long term disability benefits, unpaid benefits retroactive to the date of the denial, interest on unpaid benefits, attorney's fees and costs, a declaration that Plaintiff was totally disabled under the Plan's definition, and future payment of lon...
Alabama Court Refuses To Consider Additional Medical Evidence Submitted After Metlife's Denial Of Claimant's One Mandatory ERISA Disability Appeal
An Alabama Court recently made an interesting and important ruling in an ERISA lawsuit filed against MetLife that prohibited the Court from considering any medical evidence the Plaintiff submitted to MetLife for review after MetLife had already denied the Plaintiff's one mandatory administrative appeal allowed under the disability insurance policy (the Plan).What is an "Administrative Record" in an ERISA D...
