Disability Insurance Lawsuit Stories

In Barbara J. Nylander, M.D. v. Unum Life Insurance Company and Paul Revere Life Insurance Company, Dr. Nylander, a board-certified physician whose practice included gynecological surgery, was injured on April 21, 2015, when another doctor with whom she was performing an operation accidentally cut her index finger, severing a tendon. The injury was so serious, surgery was required to try and repair the damage....

A California federal court recently reversed Metlife's denial of long term disability benefits for a claimant with heart disease. Metlife attempted to rely on a ejection fraction rate reading as a basis to deny the claim. The Federal Judge ruled that Metlife abused their discretion and reversed the decision. In this video, we discuss the courts findings and offe...

A common question we receive is, How can an insurance company rely on their own doctors over the opinions of treating physicians? Or, How can an insurance company rely on doctors who merely review a paper file and never see the claimant in person?Unfortunately, insurance companies are allowed to do this as long as they have a good reason for doing so. If the insurance company's doctor's opinion is differen...

In this video, disability insurance attorneys Rachel Alters and Gregory Dell discuss a California Federal Court decision in which a Sunlife disability insurance denial was reversed. Rachel Alters discusses the court’s frustration with Sunlife and finding that Sunlife abused their discretion by denying long term disability benefits after paying for multiple yea...

Cal Van Steen had been employed as a Systems Integration Business Analyst at Lockheed Martin Corporation and participated in the company’s group long-term disability plan with New York Life.In 2011 while walking his dog he was assaulted during an altercation which resulted in a traumatic brain injury that affected Mr. Van Steen’s cognitive abilities, namely his abilities to concentrate, focus, organiza...

A common question we receive from claimants is how one can be approved for social security disability benefits but denied private disability insurance benefits. A recent case decided by the 11th Circuit Court of Appeals touched on this issue and reminds us that different disability programs have different standards of determining disability and it is possible to be approved under one standard of disability and...

The case of Greggory B. Owens v. United of Omaha Life Insurance Company demonstrates what a difference a day makes. All parties agreed that claimant Owens was entitled to long term disability benefits. The sole question in controversy was the date upon which he became disabled.On July 1, 2013, Owens suffered a debilitating back injury while moving furniture at work. At the time, his annual salary was $83,1...

Before degenerative joint disease of the lumbar spine forced Christopher Patterson to leave his career, Mr. Patterson worked as a Systems Analyst for a consulting firm. Mr. Patterson’s employer provided long-term disability insurance through a plan administered by Aetna Life Insurance Company.In 2001, Mr. Patterson’s back pain forced him to have lumbar surgery, after which he returned to work full-time...

This case is just another example of a Unum claim rep reviewing restriction and limitations provided by their own in-house doctors, with complete disregard for the opinions of a claimant's treating doctor. An Oklahoma Judge opined that Unum ignored the restrictions and limitations provided by the claimant's treating doctors. The claimant, a pharmacist was unable...

Flaaen v. Principal Life Insurance Company, is a win for the claimant who suffered a severe back injury in August 2005 in his job as a truck driver. In January 2006, Principal granted his application for long term disability benefits since he could no longer perform the regular and substantial duties of his own occupation.On December 14, 2014, Principal terminated Flaaen’s disability benefits on the grou...

Kelly Dean Brende v. Reliance Standard Life Insurance Company stems from a September 11, 2012, incident where Brende, a partner in a law firm, woke up one morning to discover her toes were numb. By the following day, the numbness had spread to much of her left side and she felt dizzy.She was evaluated in an emergency room, and over the next weeks and months, sought help from numerous medical practitioners....

In Johnson v. Life Insurance Company of America, a Colorado District Court ruled in favor of the claimant finding LINA’s decision unsupported by any reasonable basis. The case dealt with a denial of long term disability benefits at the change in definition from own occupation to any occupation. After paying 24 months of benefits to Ms. Johnson, LINA concluded that Ms. Johnson did not qualify for any occupati...

Hartford Disability Company, and other disability insurers, use video surveillance and field interviews as a technique to deny claims. A recent federal court case found that Hartford correctly terminated long term disability benefits for a claimant who was caught on video surveillance engaging in activities which she had claimed she could not do.In this case, after Hartford conducted its surveillance, whic...

A long term disability insurance claimant had his benefits denied when a doctor made a mistake in completing an Attending Physician Statement. Following submission of an ERISA appeal Hartford ignored the additional information submitted and once again denied the claim following an Appeal. Following the submission of a Federal lawsuit, the Minnesota Federal Judge...

This is an interesting long term disability benefit case that was litigated in the Washington Federal Court against Principal Life insurance. As we see with a lot of ERISA disability lawsuits, the insurance company denies a claimant’s long term disability claim when the definition of disability changes from OWN OCCUPATION to ANY OCCUPATION. In this case, Princ...

Mental health conditions such as anxiety and depression are two of the most common causes of disability. In a recent case against Liberty Mutual, a pediatrician claimed he was unable to work due to anxiety and depression. Liberty Mutual evaluated the doctors claim by hiring a doctor to review the medical records submitted. Based exclusively on their own psychiat...

This case was decided by a district court in Illinois and involved United of Omaha Life Insurance Company. An ERISA action was filed by the Plaintiff, Gina Tassone, after her LTD benefits were terminated. She had been paid two-years of regular-occupation benefits for her inability to work as a Finance Manager and like many group disability policies, her insurance policy’s definition of disability changed aft...

In Gray v. United of Omaha Life Insurance Co. (United), after working for a southern California television station for 15 years and rising to the position of Vice President of Sales, plaintiff was injured in a car accident. He was completely bedridden for two months and was left with limited use of his limbs and suffered from chronic pain. He attempted to return to work, using a wheelchair part-time, but it wa...

Following the submission of an ERISA disability appeal an insurance company is allotted 45 days under the law with which to render a decision on the appeal. ERISA also allows the insurance carrier a single 45 day extension to complete the review so long as the extension is for good cause. It is common for an insured to receive a letter from their disability carrier during the initial 45 day timeframe that the ...

In the case of Mokbel-Alijahmi v. United of Omaha Life Ins. Co., the 6th Circuit Court of Appeals affirmed the lower court's determination that United of Omaha improperly terminated the plaintiff's benefits after an unfair "any occupation" review. The Plaintiff in this case was a welder who spoke no English but was fluent in Arabic. His previous job required him to be able to lift 40 lbs.; however he did not n...