Disability Insurance Lawsuit Stories

An insurance company will not pay long-term disability benefits without some sort of assurance your condition is as dire as you claim. And the insurer will rarely take the claimant's word for it. Every insurance company has in-house physicians, nurses and investigators to challenge each aspect of a disability claim. What you say to your own doctors, employers or others could come back to haunt you. The recent ...

Insurance companies review the medical reasons underlying a disability benefit claim. Often, the reviewer is a doctor, nurse or economist employed on a full-time basis by the insurance company. Their job is to look for ways to deny your claim to maximize the insurance company's profit. But keeping them honest can be difficult because their training and experience can create challenges for unsuspecting claimant...

When a reviewing court considers an appeal of a disability benefit denial, it is rarely a simple question. The court has the responsibility to examine the policy, the claimant's condition and the insurance company's actions in handling the disability benefit claim. And because the insurance company has the right to make certain decisions about the policy, the court is often required to give the insurance compa...

This Johnson & Johnson disability denial lawsuit and its result shows why an experienced disability attorney is often needed prior to a disability claim denial. If the claimant in this case had hired a representative earlier in the case to assist her with her claim and administrative appeals, there is a chance that the court would have had more medical documentation in support of her claim and thus perhaps...

Liberty Mutual loses a disability claim and they still keep fighting. In a long term disability denial ERISA lawsuit against Liberty Mutual, and Indiana Federal Judge held that Liberty abused their discretion and remanded the case back to Liberty to re-evaluate the claim. The courts decision to remand the case means that Liberty Mutual essentially gets another chance to try to deny disability benefits. In most...

MetLife not only denies disability long term disability benefits to one of their own employees, but the court allows them to supplement the record after MetLife fails to respond within the 90 day ERISA appeal time period. The California ERISA disability lawyer that handled this case filed a disability lawsuit after MetLife failed to respond to his client's ERISA appeal within 90 days. After the lawsuit was fil...

What will it take for Sedgwick to stop wrongfully denying disability benefits to AT&T employees? AT&T appears to want to bury their head in the sand and act like they don't know what Sedgwick is doing. We personally think AT&T is happy with the conduct of Sedgwick as the more denials; the more AT&T can keep its money.The disability denial lawsuit discussed below is an example of the lengths...

Prudential paid total disability benefits for two years, but after certain communications from the claimant, his benefits were denied. Does doing dishes, laundry and cooking mean a person is ready to return to work 40 hours a week? Let's examine the Texas case of Patterson v. Prudential Insurance Company of America, where the claimant unsuccessfully challenged an insurance company's denial of long-term disabil...

In Texas, a claimant's ability to challenge a denial of disability benefits depends on many factors, not the least of which is whether the disability insurance policy is governed by ERISA. Another critical factor is having a good lawyer: a Texas disability attorney must have considerable experience in handling ERISA disability denials to have any chance of either winning an Appeal or convincing a judge to reve...

Since 1922, disability claimants in the state of Texas have been arguing with disability insurance companies as to whether they are entitled to "total disability" benefits. In most private disability insurance policies, "total disability" is defined as the inability to perform the substantial and material duties of your own occupation. The answer to whether a claimant is entitled to receive total disability be...

In Texas, insurance companies must treat those who purchase policies a certain way. Texas law calls it a duty of good faith a fair dealing. Experienced disability attorneys know this and make insurance companies honor their obligations under disability policies and under Texas law. Let's look at a specific example found in the recent case of Hudspeth v. Enterprise Life Insurance Company.The plaintiff there...

Insurance companies hire physicians to comb through medical files to look for a reason to deny an ERISA disability benefit claim. In a Texas case, Unum was criticized for not making relevant medical records available and for not basing its decisions on concrete medical evidence. Unfortunately, it is impossible to know what information is provided for those independent medical record evaluations without challen...

Most disability insurance policies will contain both an "own occupation" and "any occupation" definition of disability. The own occupation definition is usually only for the first 24 months of disability. After 24 months, the claimant must re-qualify for disability benefits under the any occupation definition.While most claim denials take place during the any occupation period, it is important for a claima...

One of the most hotly disputed areas among California disability lawyers focuses on the definition of "total disability" in private long-term disability insurance policies. An insurance company will routinely deny coverage, relying on policy language that, in its view, requires that the employee not only suffer from a disability but also that the disability prevents any type of work at all.These wrongful d...

Sometimes, a disability claim is doomed from the start because of specific policy language. As California disability insurance lawyers we would like to think that every disability denial is wrongful, but sometime the insurance company is correct in their decision.Our California disability attorneys are not going to accept your case if we don't think we can win your case. Disability insurance policies conta...

MetLife determined a disability claimant with Fibromyalgia was not disabled after two years of receiving benefits, but a California Federal Judge disagreed. Federal courts in California have stood behind employees and forced insurance companies to pay disability benefits. We want to be your California disability attorney and make the disability insurance company pay your benefits. The law governing disability ...

In California, Federal Judges are often limited in their ability to reverse a denial of disability insurance benefits if a disability insurance policy is governed by ERISA. A California disability attorney must be very experienced in handling ERISA disability denials to have any chance of convincing a Judge to reverse a disability claim denial. Not every policy is governed by ERISA, but if your policy is then ...

North Dakota Court Affirms MetLife Denial of Disability BenefitsOn June 5, 2012, the U.S. District Court for the District of North Dakota granted Metropolitan Life Insurance Company's motion for summary judgment against a man who had filed an ERISA lawsuit after being denied continued disability benefits. The issue with the case did not stem on whether the man was disabled. In fact, MetLife was not actuall...

When filing a disability application or appeal it is of the utmost importance to provide the insurance company all of the relevant medical records and/or documentation supporting your disability in a timely manner.If you fail to submit any important documents or records they will not be considered by the judge at a later date if your disability claim is denied.This is why it is very important to have a...

One of the largest obstacles facing an insured in bringing a lawsuit against a disability insurance company for benefits under an ERISA governed group disability policy is the inability to add additional information, in most cases medical information, to the administrative record after a final denial has been entered by the insurance company.This general rule was reaffirmed in a recent ERISA disability law...