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

Disability Insurance Law TV:
A Federal Judge's perspective on ERISA disability insurance claims

This video features Judge William Acker, Jr. testifying at Senate Finance Committee hearing discussing ERISA and long-term disability insurance claims. Disability insurance attorneys Gregory Dell & Stephen Jessup provide their thoughts on ERISA and the testimony of Judge Acker.

Disability Blog & Cases:
AETNA Life Insurance Company ordered by West Virginia Federal Judge to reevaluate denial of disability benefits to Bristol-Myers Squibb Manager

Routinely, disability insurance companies in their bid to reduce the amount of disability benefits to be awarded to disability benefits claimants will require the claimants to first apply for Social Security Disability benefits. If the claimant happened to be successful in his or her claim for Social Security Disability benefits, the insurance companies will then offset the amount of disability benefits awarded by the amount of disability benefits that the claimant received from the Social Security Administration (SSA). However, when it comes to losing out due to an SSA determination of the definition of “disability”, insurance companies will try their best to disregard the SSA determination as it is unfavorable for them financially to follow the SSA determination.

Disability Blog & Cases:
AETNA Life Insurance Company sued for failure to pay out disability benefits to ex senior nurse suffering from disabling mental conditions

On March 29th 2011, a lawsuit was filed against the AETNA Life Insurance Company (AETNA Life) at the District court for the Southern District of Florida. In the lawsuit, the plaintiff Jose Demello alleged that AETNA Life had refused to pay the disability benefits sought by the plaintiff under a group long term disability (LTD) benefits policy that was issued and administered by AETNA Life.

Disability Blog & Cases:
South Carolina disability attorneys sue Liberty Mutual three times in one week for denial of disability insurance benefits

Liberty Mutual finds itself back in court having to prove to a judge the validity of their reasons for denying yet another long-term disability insurance benefit claim. This time it isn’t just one lawsuit filed by a disability attorney on behalf of one plaintiff. As a matter of fact, the same disability attorney filed three separate Federal lawsuits against Liberty Mutual on behalf of three individual plaintiffs living in different jurisdictions.

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Disability Insurance Law TV:
A Senator's view of ERISA disability insurance claims

This video features the testimony of Montana United States Senator Max Baucus at a Senate Finance Committee Meeting. Senator Baucus focuses his testimony on the problems with ERISA disability insurance laws and the unfair claims handling practices of disability insurance companies. Senator Baucus pays specific attention to two long term disability insurance claims that were wrongfully denied by The Standard Insurance Company and Hartford Financial Insurance Company.

Disability Blog & Cases:
Reliance Standard Insurance Company and Lincoln National Life Insurance Company attempt to avoid payment of disability benefits by ignoring claimant’s application

Eric Wilson has brought a lawsuit in the United States District Court of the Eastern District of Louisiana against Reliance Standard Insurance Company and Lincoln National Life Insurance Company because the companies have refused to reply either pro or con to his petition for disability benefits in compliance with his insurance policy contract.

Disability Blog & Cases:
Sun Life Assurance Company of Canada sued by gunshot victim for failure to pay long term disability benefits

A recent Sun Life disability claim by a gunshot victim ended up as a lawsuit in the Orange County Superior Court because of the reluctance of the disability insurance company to pay out any long term benefits to its plan’s participants. In Marilyn Ellis v Sun Life Assurance Company of Canada, the plaintiff Marilyn Ellis with her California disability attorney contended that she was at all times a participant to a group long term disability plan with the policy number 63311 that was provided by the Sun Life Assurance Company (Sun Life). As such, she argued that she was a beneficiary of the plan and is entitled to the long term disability benefits that were offered in the plan.

Disability Blog & Cases:
Federal Judge orders Union Security (Assurant) to re-evaluate disability denial due to failure to consider risk of substance abuse relapse as disabling condition

In any claim for any disability benefits, the deciding factor which disability insurance companies will decide on will be whether you are what they define as being “disabled” or not. Most insurance companies however, will try to define the scope of what constitutes “disabled” as narrowly as possible to their advantage. The situation is especially compounded when a claimant is disabled due to substance abuse. Substance abuse cases involved both physical disabilities and mental disabilities...

Disability Blog & Cases:
SunLife & Aetna Life Insurance Company sued for denial of disability benefits

Here are examples of two recent cases in which SunLife Insurance Company and Aetna Life Insurance Company had a structural conflict of interest and denied disability insurance benefits. In most long term disability insurance claims which are governed by ERISA there is an inherent structural conflict of interest. The conflict of interest exist because the disability insurance company not only pays the benefits, but has the ultimate authority to approve or deny benefits. How can a disability company act a fiduciary to the insured when at the same time a decision to pay benefits will reduce the net income of the company?

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Disability Insurance Law TV:
UNUM employee deposition in a disability insurance claim denial lawsuit

This video is a portion of a video-taped testimony from a long term disability insurance claim denial lawsuit. The actual testimony in this video was presented to a jury in federal court.

Disability Blog & Cases:
CUNA Mutual terminates disability benefits to woman suffering from depression and lyme disease

A Federal Appellate Court upheld an insurance company's decision to terminate the long-term disability benefits of a woman who suffered from recurrent major depression. Although the woman claimed to now be suffering from Lyme disease, CUNA Mutual discontinued her benefits after two years due to the policy's 24 month mental illness limitation. The Court agreed with CUNA Mutual that there was insufficient evidence to support her claim of disability due to Lyme disease. Let's take a closer look to understand why the Court sided with CUNA Mutual.

Disability Blog & Cases:
Court of Appeals denies appeal for Business Executive claiming disability benefits due to lower back injury against Metropolitan Life Insurance Company

Participating in a disability insurance plan is always an excellent idea as a safeguard against unforeseen circumstances. Nevertheless, we tend to forget that when the time comes for us to try and claim our disability benefits, the disability insurance companies are always extremely reluctant to fork out what is due to us. Quite often, the language that is used in the plan issued by the disability insurance companies contains enough ambiguities and complexities for them to wriggle out of their contractual obligations. A recent opinion rendered by the Court of Appeal in the case of Michael Palmer v Metropolitan Life Insurance Company (MetLife) demonstrated just how this can happen. Although Michael Palmer's Wichita Kansas disability attorney did a commendable job in presenting this MetLife disability claim, they lost their case because there was enough leeway contained in the language of the plan which allowed MetLife to terminate Michael Palmer's disability benefits. Let us examine the case in more detail.

Disability Blog & Cases:
Prudential Insurance Company sued for denying claim for disability benefits to disabled individual suffering from chronic back and leg pain

A lawsuit seeking to recover monetary damages from Prudential Insurance Company (Prudential) was recently filed at the Supreme Court of the state of New York. In the lawsuit, the plaintiff Robert Hamil, through his New York disability attorney, alleged that Prudential's termination of his long term disability claim was in violation of his benefit rights that were protected under the Employee Retirement Income Security act of 1974 (ERISA).

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Disability Insurance Law TV:
Deposition of medical consultant hired by MetLife for a disability insurance claim

It’s hard to imagine that a person that a person undergoes a 5 level surgical fusion procedure and does not have any restrictions or limitations. That was the position taken by a medical consultant hired by MetLife. The physician in this video deposition has reviewed hundreds of long term disability claims on behalf of MetLife. This video is an excerpt from the video-taped deposition of an orthopedic physician hired by Met Life to review medical records and determine if our client had any restrictions or limitations that prevented him from performing the duties of his occupation as a chiropractor. Despite never examining our client, the MetLife hired physician determined that our client had no restrictions or limitations and he could do any activities he wishes.

Disability Blog & Cases:
New York Court upholds Hartford Insurance Company's denial of disability benefits but denies $86,000 overpayment claim

A District Court ruling issued in New York’s Southern District Court illuminates the importance of understanding the meaning of an “occupation qualifier” and/or an “earnings qualifier” requirement in your long-term disability insurance policy. In general, to qualify for disability under a policy that requires these two prerequisites you must show...

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Disability Insurance Law TV:
Who makes the final decison to approve or deny disability insurance benefits?

Is it the disability insurance claim representative or hired insurance company doctor that makes the decisional to approve or deny benefits?

FAQ | Overpayment Issues:
Can Veteran Disability Benefits be deducted from my monthly long term disability insurance check?

The answer to this question depends on the language contained within your long term disability insurance policy. In most disability claims that are governed by ERISA there is an offset provision for other disability related benefits such as SSDI, Worker Compensation or Veteran Benefits.

Disability Blog & Cases:
Pennsylvania class action disability insurance suit against Reassure and Swiss Re dismissed due to lack of subject matter jurisdiction

A federal district court in Pennsylvania recently dismissed Claimant Barry Sunshine's complaint for lack of subject matter jurisdiction. Alleging that Reassure America Life Insurance and Swiss Re Life & Health America, Incorporated prematurely terminated his and other similarly-insured individual's disability insurance benefits, Sunshine and his disability attorneys were attempting to right a wrong for not only Sunshine but for others in a similar situation. Unfortunately, the Eastern District Court of Pennsylvania dismissed Sunshine's disability insurance class action lawsuit because the suit lacked federal subject matter jurisdiction. Fortunately, the dismissal was filed as a dismissal without prejudice, making it possible for Sunshine to file an amended complaint when his disability attorneys establish proper subject matter jurisdiction.

Disability Blog & Cases:
LINA and CIGNA need to listen to the Federal Courts and stop denying disability insurance claims for people disabled by fibromyalgia

An affirming opinion from the Fourth Circuit United States Court of Appeals shows how Administrators of ERISA long term disability benefits can't abuse their power of discretion in North Carolina. This case against LINA also known as CIGNA, is a great victory for claimants suffering from fibromyalgia. In the appeal of Rebecca DuPerry v. Life Insurance Company of North America, Appellee Rebecca DuPerry prevailed in her quest to receive long-term disability benefits from her group long term disability insurance provider, Life Insurance Company of North America (LINA).

Disability Blog & Cases:
Lincoln Nebraska man suffering from fibromyalgia and chronic fatigue syndrome sues UNUM when he is denied disability benefits

UNUM Life Insurance Company of America has refused to honor its obligation to provide Scott A. Boles with his disability insurance benefit income even though Mr. Boles qualifies for benefits stipulated in two UNUM Life Insurance Company disability insurance policies. UNUM denied Mr. Bole's disability insurance benefits on both his individual disability policy, on which he has paid all premiums on time and in full since 1994, as well as an employee group disability policy from his employer that has been in effect since 2006.

Disability Blog & Cases:
Sun Life deducts veteran disability benefits from claimant’s monthly long term disability check

Most long term disability insurance policies allow the insurance company to offset the monthly disability payments to an insured if the insured is receiving “other income” from certain sources. Often, these other sources include any Social Security disability or retirement benefits, workers’ compensation benefits, retirement plan benefits from the employer, or even earnings the insured receives from any other occupation or form of employment. The specific policy language governs exactly what the insurance carrier can consider an “offset” to reduce the claimant’s monthly benefit. Sometimes, however, the insurance policy is not crystal clear on what specifically may be used as an offset. Such a situation occurred in the case of James Riley v. Sun Life Insurance Company. In this case, the issue was whether Sun Life was allowed to reduce Riley’s monthly benefit because of veteran disability benefits he received from Veterans Affairs. The Court ultimately upholds Sun Life’s decision to reduce Riley’s monthly long-term disability benefits. Let’s take a closer look to see why the Court ruled the way it did.

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