Disability Benefit Claims Law Blog : Disability Benefits Lawyer & Attorney : Dell & Schaefer : Disability Insurance Claims Law Blog

When Donna Cusson took her long-term disability case to the U.S. Court of Appeals, First Circuit on September 15, 2009, she hoped for a reversal of the U.S. District Court of Massachusetts' decision in favor of Liberty Life Assurance Company of Boston (Liberty Mutual). We have already shared the background to this case in Liberty Mutual wins long-term disability case because of video surveillance—backdrop for an unsuccessful LTD claim (Part 1). Now, we will look at both the District Court and Appeals Court decisions because the District Court's decision is what the Appeals Court would be considering.

→ Click here to continue reading Liberty Mutual wins long-term disability case because of video surveillance—how District and Appeals Courts drew conclusions (Part II)

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Donna Cusson went into Appeals Court challenging the First District Court's decision issuing summary judgment to Liberty Life Assurance Company of Boston (Liberty Mutual) and thereby upholding the disability denial. Cusson believed that the material facts in her case should have gone in her favor, not the disability insurance company's.

In this article, we will look at the background for this case. Hints as to why her appeal proved unsuccessful are found in her history.

→ Click here to continue reading Liberty Mutual wins long-term disability case because of video surveillance—backdrop for an unsuccessful LTD claim (Part 1)

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As of the time of this writing, Beverly Barker doesn't know the answer to that question. Court proceedings are complicated and seeking compensation for long-term disability benefits is no exception. A case heard in December 2009 in U. S. District Court for the Southern District of Indiana, Indianapolis Division demonstrates this yet again.

→ Click here to continue reading Will Life Insurance Company of America have to pay long-term disability benefits?

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When an insurance company uses a deliberate, principled reasoning process, supported by enough evidence, the United States court system will stand behind them. This fact is highlighted by a case that was argued before the United States Court of Appeals, Sixth Circuit, which covers the states of Kentucky, Michigan, Ohio and Tennessee. Arguments were heard by the judges on December 1, 2009 and a decision was filed on February 5, 2010.

→ Click here to continue reading Reliance Standard long-term disability benefits decision affirmed by Circuit Court

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A long-term disability case brought before Lincoln D. Almond, U.S. Magistrate Judge in the District of Rhode Island, brings to light how important it is for a long-term disability attorney to prepare a discovery request carefully and to make every effort to resolve discovery issues without involving the court system. The case we are going to discuss could have gone more favorably for Lorene Roccon Thompson, if her attorneys had paid more attention to the details. Discovery in ERISA disability cases is extremely limited and generally is only allowed to determine the extent of a conflict of interest.

→ Click here to continue reading Discovery requests in ERISA disability cases are found to be limited

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A recent short-term disability case before the United States Court of Appeals, Seventh Circuit, Chicago, Ill., demonstrates that insurance companies are no friendlier to their own employees than anyone else. Kirsten Majeski worked for Metropolitan Life Insurance Company (MetLife) as a nurse consultant until June 2006 when she began complaining of pain and numbness in her shoulders, arms and hands. She was diagnosed with cervical radiculitis, a disorder of the spinal nerve roots.

→ Click here to continue reading MetLife must reconsider denial of benefits for former MetLife employee

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In this article, I want to highlight, once again, the importance of rendering timely responses to correspondence from your long-term disability insurance company. I also want to highlight the importance of paying attention to statutes of limitations. A long-term disability case that came before the United States Court of Appeals 11th circuit recently highlights these issues.

The foundation of this case began back in 1999. Stuart S. Johnson, a participant in a group disability policy issued by Unum Life Insurance Company of America (Unum), applied for long-term disability benefits. Unum denied his application. The administrative appeals process allowed him to request review of the decision three times. Johnson appealed three times and was denied each time.

→ Click here to continue reading Unum's denial of disability claim is upheld after court finds claimant failed to respond in a timely manner

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Shirley Graham, an employee with the U.S. Postal Service (USPS) who participated in a long-term disability plan administered by Hartford Life and Accident Insurance Co. (Hartford), brought her case recently before the United States Court of Appeals, Tenth Circuit. Her appeal raised three issues: 1) Did the District Court rule correctly that her disability benefits plan did not qualify as a governmental plan? 2) Was the District Court's determination that her claim did not qualify for a jury trial correct? 3) Did the District Court made the right determination when it failed to find Hartford's denial of benefits arbitrary and capricious.

To understand Graham's claim we will look at the background of her claim.

→ Click here to continue reading Postal worker loses long-term disability claim against Hartford Insurance

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When Laurie Cooper walked into the U.S. Court of Appeals, 5th Circuit, in New Orleans, she had to demonstrate before the court that she had been denied a full and fair review of her claim and that the denial of her benefits abused the discretion given the benefit provider, Hewlett Packard Company Disability Plan. Two out of three judges found that she had failed to do this. In a two-to-one decision, the ruling from the U.S. District Court for the Southern District of Texas was affirmed.

The end result? Ms. Cooper will not receive long-term disability benefits. Let's look at this case and see how the circuit judges reached their conclusions.

→ Click here to continue reading Hewlett Packard's denial of disability benefits is upheld by appeals court

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Another case highlights the importance of making timely appeals when your long-term disability benefits are denied. Richard MacLennan discovered this when he took his case to court against Provident Life And Accident Insurance Company (Provident).

MacLennan filed his case in the U.S. District Court, District of Connecticut. In his claim, MacLennan sought to take advantage of tolling, a legal doctrine that allows for a statute of limitation to be extended. "Equitable tolling" can delay the initiation of a statute of limitations or it can halt the countdown of time after it has started.

→ Click here to continue reading Long-term disability claim against Provident almost lost because of untimely appeals

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When Judge Stephen V. Wilson delivered his decision on January 13, 2010, it probably resulted in some mixed feelings for Kelly Lavino. She had hoped for a clear victory in her battle with Metropolitan Life Insurance Company (MetLIfe) to have her long-term disability benefits restored. Instead the judge rendered a decision that may put her at the insurance company's mercy once again.

Lavino had been a project engineer for Malcolm Pitnie, Inc. One of the benefits of employment included coverage under a short-term and long-term disability plan issued by MetLife. This entitled Lavino, if she became and remained disabled, to long-term disability benefits.

→ Continue reading MetLife abused its discretion when it terminated long-term disability benefits

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January 13, 2010 was a good day for Kelly Lavino. U.S. District Court, Central District of California Judge  Stephen V. Wilson ruled that Metropolitan Life Insurance Company (MetLife) wrongfully denied disability benefits and abused its discretion when it decided to terminate Lavino’s long-term disability benefits. Let's review what Judge Wilson considered as he made his decision.

→ Click here to continue reading MetLife terminates long-term disability benefits to woman with fibromyalagia

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Verla Hancock participated in a group benefit plan sponsored by her employer, Intermountain Healthcare. The plan's claim fiduciary was Metropolitan Life Insurance Co. (MetLife). Under the plan, Verla obtained basic life insurance, supplemental life insurance and accidental death and dismemberment coverage (AD & D).

The plan stipulated that in order to benefit from the AD & D coverage, the policy holder had to be 1) Injured in an accident; 2) The accident had to be the sole cause of injury; 3) The accident had to be the sole cause of death; 4) The death had to occur within 365 days of the accident. The District Court found that policy beneficiary Terri Hancock had failed to demonstrate that she had a claim against MetLife for accidental death and dismemberment in her mother's death.

Would Terri Hancock's appeal be successful? Let's look at the facts surrounding Verla Hancock's death.

→ Click here to continue reading 10th Circuit Court of Appeals validates MetLife's accidental death and dismemberment denial

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Ronnie Hogan sued Provident Life & Accident Insurance Company (Provident) and Unum Group Corp. (Unum) asserting claims under Florida law that the insurance companies had failed to attempt in good faith to settle his claim. Hogan also accused the insurance companies of making misrepresentations that would have made a settlement less favorable for him. He accused them of exercising general business practices that involved mishandling claims, breaching their fiduciary duty, common law fraud, negligence and even conspiracy to commit statutory violations. Provident and Unum asked the judge to dismiss Hogan's case based on a failure to state his claim or at least to pass judgment based on the pleadings presented by the two sides.

→ Click here to continue reading Unum's claim handling exposes them to a multi-million dollar bad faith disability lawsuit

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Lynda Sacks worked as a mortgage loan underwriter for Countrywide Home Loans, Inc. Her employer offered both short-term and long-term disability plans issued by Standard Insurance Company (Standard) effective January 1, 2005. Standard was responsible for funding both disability plans and making the claims determinations.

→ Click here to continue reading Standard Insurance denies disability claim to a wheelchair bound woman

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