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California Court Rejects Liberty Life Insurance Company’s Attempt to Apply ERISA Law to a Non-ERISA Disability Policy

Posted in Disability Insurance Industry News

Although this California non-ERISA disability policy litigation was not handled by our disability insurance lawyers, it is relevant to contract law for those who are employed by a state or federal government and have long term disability policies not covered by ERISA.

California insurance law, not ERISA, applies to a lawsuit against a disability insurer by a former government employee

The plaintiff in Klees v. Liberty Life Assurance Company of Boston, a former employee of the University of California, a governmental employer, was initially approved for long term disability benefits due to her many medical conditions, including fibromyalgia, seronegative inflammatory arthritis and injuries she had suffered in a car accident.

When Liberty terminated the plaintiff’s benefits, she filed a lawsuit alleging breach of contract and breach of the covenant of fair dealing. Liberty responded and, among other arguments, relied on published cases citing the Employees’ Retirement Income Security Act (ERISA) in a motion to dismiss the lawsuit. The California federal court labeled Liberty’s citations of ERISA law as a “red herring” in that ERISA specifically exempts government employers from its provisions.

The termination of long term disability came after three independent medical examiners determined the plaintiff could work in some capacity. Liberty tried to convince the court to apply the ERISA definition of disability instead of using the definition of disability as it was defined in the policy terms. The California federal court had no patience with Liberty stating, “ERISA cases are irrelevant to California insurance law.”

Since the question of whether or not the plaintiff was totally disabled under the terms of the contract required resolution under California insurance law, and not by the definition of disability found in inapplicable ERISA law, Liberty’s motion to dismiss the lawsuit was denied.

If you have questions regarding your claim for disability benefits, or if your disability claim has been denied, call Disability Attorneys Dell & Schaefer for a free consultation.

Claimant Actively Seeking Employment Denied LTD Benefits By Anthem

Posted in Anthem, Disability Insurance Cases Nationwide

The case of Kindig v. Anthem Life Insurance Company provides an example of how claimants of long term disability benefits may sabotage their own case. A New York Federal Court concluded that Anthem did not act arbitrarily or capriciously by terminating benefits to its claimant following his hip replacement surgery when the court found:

1) his treating physician concurred with the reviewing physician’s report that he was not disabled; and
2) the claimant was actively seeking similar employment with other companies.
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If Claimant Can Work in Own Occupation She Can Work in Any Occupation

Posted in Disability Insurance Cases Nationwide, Reliance Standard

In Okuno v. Reliance Standard Life Insurance Company, the plaintiff was diagnosed with Crohn’s disease, Sjogren’s syndrome and possibly narcolepsy. Her claim for long-term disability was denied when Reliance determined she could perform the duties of her own occupation. She exhausted her administrative remedies and filed this lawsuit under the provisions of ERISA. In court, she claimed Reliance erred in determining she was not disabled from her own occupation instead of analyzing whether she was disabled from any occupation. The district court disagreed with the plaintiff holding that when Reliance determined she could perform her own occupation it “of course recognized that she could perform a job fitting within the plan definition of ‘any occupation.'”
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Hartford’s Attempt to Limit a Nurse’s Long Term Disability Claim Is Reversed By Illinois Federal Judge

Posted in Disability Insurance Cases Nationwide, Hartford


A recent case out of the Northern District of Illinois reminds us of the hundreds, maybe thousands, of disability insurance cases we have had against Hartford insurance company. Although we did not handle this particular case, we believe our video and discussion about this recent case will be helpful to those who have had their long term benefits terminated.

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