Disability Insurance Lawsuit Stories

In a ruling filed on November 17, 2009, the United States Court of Appeals for the Eighth Circuit found that Prudential Insurance Company of America (Prudential) had failed to provide Barbara Brown adequate information with which to appeal their decision to deny her long term disability (LTD) benefits. As a result, the court did not apply a common court-approved practice which demands that all administrative o...

The Third Circuit Court of Appeals recently rendered a very difficult decision in favor of Hartford Insurance Company dealing with the interpretation of pre-existing condition clauses in long-term disability income policies.  The three judge panel ruled 2-1 in favor of upholding Hartford's denial of disability benefits.  The law in each state is different for pre-existing conditions, therefore a disa...

Once again the Ninth Circuit U.S. Court of Appeals has upheld a state's rights to protect employees that have long-term disability insurance policies issued by their employers. In an opinion filed on October 27, 2009, three circuit judges on the ninth circuit reached a unanimous decision that a state's practice of disapproving insurance policies that contain clauses that vest insurers with discretion in how th...

On November 4, 2009, a ruling was handed down in the Sixth Circuit Court of Appeals that will surely have insurance companies looking at how they define "pre-existing condition". Ruth Mitzel is certainly happy that the court affirmed the lower court's decision that Anthem Disability Insurance Company, her employer and insurer, had wrongfully denied her long-term life insurance benefits.When Mitzel was diag...

After receiving disability benefits for more than 10 years, the Reliance Standard denied disability benefits. After a 4 year legal battle, the Arizona district court determined that Melisa Gemmel was disabled by fibromyalgia. Melissa Gemmel was employed at Systemhouse, Inc. and covered under her employer's long-term disability plan, issued by Reliance Standard (NYSE:DFG). In 1989, it was discovered that Gemmel...

It is vital that you hire the right long-term disability firm to represent you. Debra Swanson had to learn this the hard way, as a recent ruling in the Fifth Circuit court of Appeals in the Southern District of Texas demonstrates. How did Swanson's attorney fail her? Her counsel failed to file a proper appeal.Swanson's story begins in January of 2002, when she was approved for long-term disability benefits...

Aside from the fact that many disability insurance companies already have a conflict of interest for being both the administrator of benefits and the entity that decides whether or not an employee qualifies for disability insurance, there are some cases in which it appears that insurance companies simply decide they don't want to pay disability benefits.Pamela Alexander began suffering with pain in 2002, ...

Alvin Hintz was an employee of CCL Custom Manufacturing, Inc. as Director of Information Systems for more than a decade. The company was purchased prior to Hintz's termination, by KIK Custom Products, Inc. On August 8, 2005, Hintz was terminated along with eight other employees. In the separation agreement, there was a 'general release of claims' that Hintz signed. The long term disability plan was a...

When you apply for a disability policy, it is very important to answer all questions as truthfully as you can. The courts generally will not render a summary judgment in favor of the disability insurance company if the company can't prove that you answered a question with the intent to defraud. If you don't have a solid explanation for why you answered a question falsely, you may find yourself losing your cove...

Donna Blake was an employee of Express Scripts, covered under both a long term disability plan and a short term disability plan, when she applied and was denied for short term disability coverage.  After internal appeals, Mrs. Blake brought her claim to the United States District Court, Missouri Eastern Division.  Upon the settlement of Mrs. Blake's claim for short term disability, she claimed that s...

When Vickie Costello left work on May 19, 2006, after a stressful encounter with one of her co-workers, she had no idea that her problems were going to get even worse. In order to return to her job at Logan Aluminum, Inc., her employer required her to sign a "last chance agreement." Already suffering from debilitating pain for which she had been under a physician's care since 1999, Ms. Costello felt that this ...

When Dr. Beatriz Martinez received a letter from MetLife denying her claim for long-term disability insurance, her only remaining option was to file a lawsuit. Unfortunately for her, the court upheld Met Life's denial for one primary reason, she filed her claim for disability benefits four months too late. No arguments put forth by her attorneys could change that fact, and in the end, her appeal was denied, an...

Mrs. Pettigrew was an employee of Pioneer Automotive Technologies, Inc from December 8, 2003 until May 15, 2006.  Her most recent position was that of a senior engineer.  Mrs. Pettigrew had been experiencing increasing pain and symptoms of Chronic Fatigue Syndrome (CFS), Fibromyalgia and Radiculopathy.  Because of the increasing problems Mrs. Pettigrew was facing, she was finally forced to stop ...

For several years, Elizabeth Black was the executive director of Milwaukee World Festival, Inc. (MWF), the organization that governs Summerfest, a music festival in Milwaukee.  Black was covered under the company's disability insurance plan, underwritten and administered by Standard Insurance Company.  Black was diagnosed with multiple aortic aneurysms, bulging and weak areas in the aorta.  In 2...

Mrs. Kaufmann was employed as a senior project manager by Siemens Corporation.  Mrs. Kaufmann was a member of the long term disability plan through MetLife, who was both the administrator and payor of disability benefits.  On May 26, 2006, Mrs. Kaufmann stopped working on advice from her treating physician, Dr. Daniel T. Rubino.  Because of an unsuccessful diskectomy and laminectomy, Mrs. Kaufma...

Annette Engel was employed with Harborcreek Youth Services as a Clinical Director, where she performed duties such as providing leadership and vision, developing proposals, overseeing interviews and recruits of other clinicians, consultation and more. On September 5, 2007, Mrs. Engel applied for long term disability benefits under her employer's plan with Jefferson Pilot (aka Lincoln National), claiming f...

Mrs. Rebecca Duperry worked as payroll benefits HR administrator for Railroad Friction Products Corporation (RFPC) until April 7, 2006.  Mrs. Duperry suffered from rheumatism, and stopped working in April pursuant to the advice of her rheumatologist.  The rheumatologist told Duperry to 'low her work down' and that cutting hours was a good idea, although working from home would be an even better idea....

In February of 2006, Mrs. Lanoue was a table games floor person for the Mohegan Tribal Gaming Authority and had been since October of 1997.  She was covered under the long-term disability plan issued and funded by Prudential Insurance Company of America (NYSE:PRU).  In April of 2006, Mrs. Lanoue filed for long-term disability, claiming to have chronic pain, fatigue and fibromyalgia.  Her claim i...

Individuals who pay for disability insurance premiums hope to be able to rely on the disability benefits if they are ever unable to work for any extended period of time. However, many times these employees' claims are denied without any reasonable basis for denial. As in the case below, it is often abusive claims handling tactics by disability insurance companies that leads to disabled individuals being denied...

Disability Insurance Policies are complicated legal documents that are unfortunately difficult for most individuals to properly understand. While a disability policy is intended to be drafted so that a claimant will clearly understand all of the terms and conditions, a claimant's misunderstanding can jeopardize a claimant's right to disability benefits. A recent disability case reveals the importance of comply...