Disability Insurance Lawsuit Stories

Factual OverviewMichelle Duncan worked for 22 years for Verizon. She started with the company upon her graduation from high school back when Verizon was known as U.S. West Paging. She worked her way up the ladder to the position of Global Enterprise Manager. It was a high-pressured job requiring travel and dealing with hundreds of email communications every day.In 2010, she began having auditory halluc...

In Carr v. John Hancock Life Insurance Co., plaintiff David Carr, a former Shell employee, suffered from a number of illnesses including anxiety, hypertension and prostate cancer. Additionally, he was legally blind. While employed at Shell, he was covered by a Group Long-Term Care Insurance policy.Benefit ProvisionsAccording to the written terms of the policy, Carr was eligible for benefits if, due to ...

In Owens v. Metropolitan Life Insurance, Judge Richard Story of the Northern District of Georgia Federal Court found that MetLife breached its duty to Laura Owens and similar beneficiaries. In April of 2012, Robert Owens died, leaving Laura a widow. Through his employer, Robert had life insurance from MetLife.MetLife approved Laura Owen’s life insurance claim and established a “Total Control Account”...

In Hutchings v. Lora Lyons, Plan Administrator, and Ball Industries Employee Injury Benefit Plan, et al. (Defendants), plaintiff Linda Hutchings injured her knee while at work. Her initial request for disability benefits was granted so she could have surgery for a torn right medial meniscus. The surgery was not successful.Just a few months later, she requested disability benefits so she could have a total ...

In Brown v. United of Omaha Life Insurance, United unsuccessfully tried to avoid paying a death benefit to Lloyd Brown III, the beneficiary of a life insurance policy chosen by his father, Lloyd Brown II. Ultimately, Brown III won, but the case was remanded to the district court to determine the exact monetary amount of his award as well as the amount of attorney’s fees and prejudgment interested to which Br...

In Mendez v. FedEx Express and Aetna, plaintiff Miguel Mendez had worked 28 years as a delivery driver for FedEx when he was severely injured in a car wreck. He suffered a traumatic brain injury (TBI), a splintered pelvis and multiple other orthopedic injuries. Aetna, plan administrator for FedEx, initially granted Mendez’s application for disability benefits.Since Mendez was unable to work in his own oc...

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 hi...

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...

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 Re...

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 Ma...

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 significant...

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 FactsIn 1991, the plaintiff, Carole Cheney, began workin...

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 sympto...

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 ...

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...

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 pree...

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 suffe...

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 herniat...

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 lo...

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...