This Week on DIAttorney.com (02/04/2012)

Disability Blog & Cases:
Texas claimant takes Reliastar to task for denied disability benefits

Suffering from multiple medical conditions and unable to function in a daily job, a health care professional and her Texas disability lawyer filed a lawsuit against Reliastar Life Insurance Company to force the insurer to pay disability benefits as contracted in an employee welfare benefit plan.


Disability Blog & Cases:
Wells Fargo disability claimants in Alabama and Florida file lawsuits against Liberty Life Assurance Company of Boston for unpaid long term disability benefits

Wells Fargo disability claimants in Alabama and Florida file lawsuits against Liberty Life Assurance Company of Boston for unpaid long term disability benefits

Recently, two Wells Fargo employees were forced to file Federal Lawsuist against Liberty Life after being denied disability benefits. Utilizing the services of an Alabama Disability Attorney and a Florida Disability Lawyer, the two lawsuits are currently pending. Let’s take a closer look at both cases:


Disability Blog & Cases:
Tempur employee suffering from chronic fatigue syndrome sues Union Central Life for denial of disability benefits

A federal lawsuit was recently filed in the U.S. District Court in Pennsylvania against the Union Central Life Insurance Company (Union) by a Pennsylvania disability attorney. The Plaintiff, Janet G., worked as a Direct Sales Supervisor for Tempur World, Inc. (Tempur). Due to her employment at Tempur, Janet was provided long-term disability insurance with Union Central.

Southern Freight and Nu Skin employees sue Reliance Standard for failing to pay disability benefits

Two different ERISA lawsuits were recently filed by disability attorneys in California and Florida against Reliance Standard Insurance Company for the wrongful denial of disability benefits.
 

The First Case

In the first case, the plaintiff, through a California disability attorney filed a lawsuit in the District Court for Eastern California. The plaintiff was employed by Nu Skin Enterprises. While working for Nu Skin Enterprises, the plaintiff participated in Nu Skin's Long-Term Disability Package to its employees. Reliance was the plan administrator for the disability insurance plan.

The plaintiff applied for Long Term Disability through Reliance on June 1, 2007 due to falling ill and experiencing severe pain in both his hips and knees that kept him from being present at work and being unable to perform the duties of his position for three continuous years. Reliance stated its approval of Plaintiff's claim for benefits on December 14, 2007. Plaintiff applied for Social Security benefits as required by the Plan and his disability began on June 1, 2007. Plaintiff received a back award of $21,769.68 from the Social Security Administration and made a payment in this same amount to Reliance to meet the terms of the Plan. Plaintiff still receives Social Security Disability Benefits.

On September 29, 2009, Reliance informed Plaintiff that further long-term disability benefits would be denied based on the condition that the Plaintiff was suffering from a mental or nervous disorder. Reliance informed Plaintiff that because he was not in a Hospital or Institution, he could not receive further payments beyond August 30, 2009, 24 months after the first benefits were paid out.

The plaintiff appealed the denial and was issued a final denial by Reliance on October 26, 2010. In the lawsuit, the Plaintiff alleged that Reliance breached the terms of the Plan, which has caused the Plaintiff to suffer currently and to continue suffering in the future.

The Second Case

The second lawsuit was filed at the Middle District Court for the District of Florida by a Florida disability attorney. The plaintiff in this case was an employee for Southern Freight. He was provided with a LTD coverage plan that was fully insured by Reliance. Plaintiff received short-term benefits that ran from January 26, 2010 to April 27, 2010. However, despite continuing to fulfill the definition of "disabled" as defined by the Plan and being backed by the written testimony of his physicians, Reliance denied LTD benefits on July 21, 2010.

Relief Sought in the Lawsuits

In the aforementioned cases, the relief sought by the plaintiffs from Reliance in their lawsuits comprises of:

  • A declaration that the plaintiffs are entitled to LTD benefits under their respective plans
  • Benefits that are due and have not been paid, as well as interest
  • An award of attorney's fees and costs
  • Any other relief that the court deems just and appropriate
     

About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. Request a free legal consultation here or call 800-698-9162.

9th Circuit U.S. Court of Appeals determines that an Insurance Company and other entities may be sued in cases involving long term disability benefits

June 22, 2011 - A recent opinion from the Ninth Circuit United States Court of Appeals has helped clarify the rules as to who you can sue in actions for benefits under a long term disability policy See Cyr v. Reliance Standard & Channel Technologies, 2011 WL 2464440, June 22, 2011. The Court concluded that under appropriate circumstances, an entity other than the plan itself or the plan administrator may be sued under 29 U.S.C. § 1132(a)(1)(B).

Laura Cyr was employed by Channel Technologies, Inc. ("CTI") as a vice president. CTI provided its employees with long term disability benefits under a program insured by defendant Reliance Standard Life Insurance Company ("Reliance"). CTI was the plan administrator, and Reliance effectively controlled the decision whether to honor or deny a claim for benefits. In October 2000, Cyr filed a claim for long term disability benefits based on a back condition. Reliance approved the benefits and based her monthly payment on her salary of $85,000/year.

Ms. Cyr later filed suit against her employer, CTI, alleging gender discrimination. A settlement agreement was eventually reached which awarded Cyr a retroactive salary of $155,000/year. When Cyr asked Reliance to increase her monthly benefit amount in accord with her adjustment in salary, Reliance declined. Cyr was forced to file suit to pursue her claim for the increased benefits.

Cyr filed suit against Reliance, the CTI Group Long Term Disability Benefit Program (the 'Plan'), and CTI as the plan administrator for the Plan. Reliance moved for summary judgment, arguing that only the plan or plan administrator could be held liable under the statute. Initially, the district court agreed with Reliance, but later the court changed its mind and ruled in favor of Cyr. Cyr was awarded fees, costs and interest on the money owed. In light of this ruling, Reliance appealed.

The issue for the Appellate Court was whether Reliance was a proper defendant in a suit for benefits under 29 U.S.C. § 1132(a)(1)(B) even though it was neither a plan or plan administrator. The Court first noted that neither 29 U.S.C. § 1132(a)(1)(B) nor 29 U.S.C. § 1132 stated any limits about who could be sued. Additionally, the Appellate Court looked to a United States Supreme Court ruling for guidance. In Harris Trust & Savings Bank v. Salomon Smith Barney, Inc., 530 U.S. 238 (2000), the Supreme Court addressed a similar question of who can be sued under a similar statute, 29 U.S.C. § 1132(a)(3). In that case, the Supreme Court noted that 29 U.S.C. § 1132(a)(3) makes no mention at all of which parties may be proper defendants. The Court then ruled that there was no limit in 29 U.S.C. § 1132(a)(3) as to who could be sued.

Similarly, in the case at hand, the Appellate Court felt that because 29 U.S.C. § 1132(a)(1)(B) contained no limitation as to who could be sued, the Court could not read a limitation into the statute. The Court concluded that parties other than plans can be sued for money damages as long as that party's individual liability is established. The Court looked to related section 29 U.S.C. § 1132(d)(2) which provides that 'any money judgment under this subsection against an employee benefit plan shall be enforceable only against the plan as an entity and shall not be enforceable against any other person unless liability against such person is established in his individual capacity under this subsection.'

In the case at hand, the Court determined that Reliance, as plan insurer who is responsible for paying legitimate benefits claims, is a logical and proper defendant for Cyr to recover benefits due, along with the plan and the plan administrator. The Court denied Reliance's appeal.

This Week on DIAttorney.com (05/28/2011)

Disability Blog & Cases:
20 years of receiving disability insurance benefits and CIGNA denies woman's benefits three separate times

A federal lawsuit recently filed in Pennsylvania against Cigna Insurance Company portrays a woman’s 21 year on and off battle with Cigna in order to maintain her long term disability benefits. When dealing with disability insurance companies, it is always a good move to have a disability attorney to handle your monthly disability payments. This is because the disability insurance companies are constantly reviewing your case and will try to look for a reason to terminate your long term disability (LTD) benefits. To them, you represent a “leak” in their bottom line, their profitability. So no matter how flimsy the reason maybe, disability insurance companies are not beneath their stations in trying cut off your long term disability payments. The case of Teann J. Scoggins v Life Insurance Company of America/CIGNA filed recently at the Distinct Court by the plaintiff’s Pennsylvania disability attorney alleges malicious behavior on the part of the disability insurance companies.


Disability Blog & Cases:
Pizzeria owner suffering from Celiac disease filed lawsuit against Berkshire Life Insurance Company of America for breach of contract in refusing to pay disability benefits

Recently a lawsuit was filed against the Berkshire life Insurance company of America at the Circuit Court for the County of Wayne in Michigan by an owner and operator of several pizzerias through his Michigan disability attorney. The disability lawsuit was filed after Berkshire evaluated the disability claim and made a determination that the claimant was not disabled.


Disability Blog & Cases:
Former security guard of the Children's Hospital of Philadelphia alleges CIGNA Insurance engaged in fraudulent and malicious disability claims practices

Recently, a CIGNA claim denial lawsuit was filed in District Court for the Eastern District of Pennsylvania by a disabled individual who was a former cop and ex security guard of the Children’s Hospital of Philadelphia through his Pennsylvania disability lawyer. The details of the lawsuit were somewhat disturbing as it alleges how, CIGNA also known as Life Insurance Company of America (LINA), fraudulently and willfully victimized the plaintiff in its quest to rid itself of an unprofitable policy account.


Disability Blog & Cases:
Former Aegon USA employee suffering with multiple sclerosis sues CIGNA for denial of disability insurance benefits

A recent disability insurance lawsuit filed at the District Court for the Eastern District of Wisconsin can serve as an eye opener to the kind of claims handling practices that CIGNA will employ in order to evaluate a CIGNA disability claim. In Laura McBrien v CIGNA Life & Health Insurance/Life Insurance Company of North America, the plaintiff Ms. McBrien filed a lawsuit under the Employee Retirement Income Security Act of 1974 (ERISA) through her Wisconsin disability lawyer to try and recover long term disability (LTD) benefits which she was and is legitimately entitled to. Allegedly, CIGNA Life had been relentless in denying the critically ill woman her claim despite the overwhelming medical evidence supporting her claim.


Disability Blog & Cases:
City University Of Medicine & Bioscience former employee disabled by back disorder sues Reliance Standard Life Insurance Company for denial of disability benefits

Back pain is one of the leading causes of claims for long term disability benefits against disability insurance companies. However, claimants of disability insurance benefits who are suffering from back disorders often have an uphill task in trying to claim their disability benefits from Disability Insurance Companies. This is because disability insurance companies can try to deny the claims of individuals who are suffering from back disorders by claiming there is no objective medical evidence to support a claimant’s subjective complaints of back pain. Hence, it is not surprising that we often see lawsuits filed against disability insurance companies from individuals disabled by chronic back pain...

This Week on DIAttorney.com (05/07/2011)

Disability Insurance Law TV:
Did UNUM insurance disability claims examiner understand physician's job duties?

This video is a small portion of the video-taped trial testimony of a Unum long term disability employee. The deposition was completed on behalf of our client by attorney Gregory Michael Dell.


Disability Blog & Cases:
UNUM sued by Ohio disability attorney for failure to pay disabiity insurance benefits to ex-nurse restricted to using a cane or motorized scooter to get around

Karen Russell has filed a lawsuit against her previous employer and UNUM Life Insurance Company of America in an attempt to collect her long term disability benefits in the United States District Court of the Southern District of Ohio Western Division. In her complaint, Russell asks the Court to order Defendant UMUM to pay her long term disability payments as is proper under her ERISA-controlled plan with her previous employer. In addition to disability benefits, Russell has petitioned the Court for attorneys’ fees and any other relief it deems appropriate.


Disability Blog & Cases:
Prudential Insurance Company sued for denial of disability benefits to former U.S. FoodService Inc. sales analyst with back disorder

Having exhausted all her disability insurance appeals and her patience, Torey Robinson filed a lawsuit in the United States District Court for the Southern District of Texas, Houston Division against Prudential Insurance Company in an effort to collect her back and future disability benefits as stipulated in her Prudential Insurance policy. With no more ERISA disability administrative remedies to pursue, Robinson felt she had no other choice but to file a lawsuit to collect her disability benefits and let the Court decide the merits of her claim for disability benefits.


Disability Blog & Cases:
Liberty Mutual Life Insurance denies disability benefits for depression despite two hospitalizations by claimant

Mary Denny and her Massachusetts disability attorney recently filed a civil complaint in United States District Court in the Eastern Division of the District of Massachusetts against Liberty Life Assurance Company of Boston (Liberty) for Liberty’s refusal to pay Ms. Denny long-term disability benefits.


Disability Blog & Cases:
Reliance Standard Life Insurance Company sued by occupational therapist for denial of disability insurance benefits

Occupational therapist Ernesto R. Campos has filed a lawsuit naming Reliance Standard Life Insurance Company, Rehab America, Inc., Group Long-Term Disability Insurance Plan and Rehab America, Inc. as the defendants. Campos and his Tennessee disability lawyer filed his complaint in the Western District of Tennessee Eastern Divisional Office at Jackson concerning a disability insurance plan under ERISA...


Disability Blog & Cases:
If you can afford it, then you should only buy an individual disability insurance policy

In the case of Fleisher v. The Standard Insurance Company filed in New Jersey Federal Court, the court recently rendered a decision which can have a negative impact for numerous physicians and other business professional that have Group Association Policies and also have an ERISA governed group policy from their employer. Numerous medical, dental, legal, accounting, nursing and other professional associations across the country offer a group disability insurance policy to all of their members...

This Week on DIAttorney.com (04/23/2011)

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?

ERISA disability claimants can receive attorney fees with "some degree of success"

On May 24, 2010, the United States Supreme Court rendered an opinion in the case of Hardt V. Reliance Standard, which is a major victory for disability insurance claimants that have a long-term disability policy governed by ERISA. Reliance Standard, a disability insurance carrier attempted to argue that a disability claimant was not entitled to attorney fees because she was not a "prevailing party" after her case was remanded back to Reliance. For a background summary of this case see Can I recover attorney fees if my long-term disability claim is governed by ERISA?

→ Continue reading ERISA disability claimants can receive attorney fees with "some degree of success"

Are attorney fees payable in long term disability insurance cases governed by ERISA?

Imagine a disability claimant has their long-term disability claim denied, files an appeal which is denied, then files a lawsuit to recover disability insurance benefits. After 2 years since the first denial and hundreds of hours of litigation, the court says the disability carrier needs to reconsider their claim denial. The disability carriers argues that the court sending the claim back for another review is not a victory by the claimant and the claimant's attorney is not entitled to collect attorney fees.

This is the exact argument that Reliance Standard has made in a further effort to make it more difficult for claimants with ERISA governed long-term disability policies to collect benefits. Most disability case victories result in the court remanding the case back to the company for an additional review. If a court's remand of the case back to the disability company is not considered to be a victory, then there will be very few cases in which the disability carriers will be responsible for attorney fees.

→ Continue reading Are attorney fees payable in long term disability insurance cases governed by ERISA?

Reliance Standard long-term disability benefits decision affirmed by Circuit Court

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

Disability Claimant Takes Reliance Standard To Court Twice Within 5 Years

A ruling in U.S. District Court for the Southern District of New York found Reliance Standard Life Insurance Company (“Reliance”) acted in an arbitrary and capricious manner when it denied Elizabeth Diamond long-term disability benefits. Here is her story.

Ms. Diamond worked for Paine Webber as a desktop publisher. Coverage from Reliance through a Group Long Term Disability (LTD) Insurance Policy paid for by her employer was included in her benefits package. Ms. Diamond fell ill and ceased working on September 9, 2000. She first applied for long-term disability benefits in early March of 2001.

Click here to continue reading Disability Claimant Takes Reliance Standard To Court Twice Within 5 Years

Arizona Court Reverses Reliance Standard And Awards Disability Benefits to Woman Suffering From Fibromyalgia

After receiving disability benefits for more than 10 years, the Reliance Standard denied disability benefits. After a 4 year legal battle, the Arizona district court determined that Melisa Gemmel was disabled by fibromyalgia. Melissa Gemmel was employed at Systemhouse, Inc. and covered under her employer’s long-term disability plan, issued by Reliance Standard (NYSE:DFG). In 1989, it was discovered that Gemmel suffered from osteophytes in the neural canal at C5-6, a posterior osteophyte at C5-6, and a C7-T1 abnormality.

Click here to continue reading Arizona Court Reverses Reliance Standard And Awards Disability Benefits to Woman Suffering From Fibromyalgia