If you have Aetna Insurance and hold a Disability Insurance Policy with them, this is a video you need to see. A policy holder with Aetna tried to file a claim after being diagnosed with an aggressive form of cancer and becoming disabled due to treatments.
Continue Reading Aetna Approves then Denies Disability Claim Based on Pre-Existing Conditions Clause

Attorneys Gregory Dell and Cesar Gavidia discuss problems encountered in litigation on behalf of a client who had a stroke. He returned to work, but three years later filed a claim for long-term disability benefits with Aetna Disability Insurance. Aetna agreed with his treating neuropsychologist that he could not work in his own occupation due to his symptoms indicating cognitive, visual, auditory, spatial, and perception issues and awarded him benefits.
Continue Reading Disability Attorneys Discuss Aetna’s Denial of LTD Benefits to Software Engineer Who Suffered a Stroke Followed by Cognitive Losses

In this video, disability insurance lawyers Gregory Dell and Cesar Gavidia consider the effect on Amazon workers’ disability claims now that Hartford has bought the Aetna Disability Insurance Company. They conclude that changes will be unlikely since both companies now engage in extensive and exhaustive claims review, using every possible avenue they can to avoid paying long-term disability claims.
Continue Reading Disability Attorneys Discuss Hartford’s Purchase of Aetna and How It May Affect Amazon Workers

Davis v. Aetna Life Insurance Company (Aetna) involves a case where a plaintiff filed an ERISA lawsuit against Aetna alleging that she should receive long-term disability benefits under her employee benefit plan. As it turns out, there was no evidence she had ever submitted a claim for benefits. When Aetna filed its Motion for Summary Judgment, plaintiff failed to file an opposition. The Court determined there was no material issue of triable fact and granted Aetna’s motion.
Continue Reading Louisiana Court Grants Aetna’s Unopposed Summary Judgment Motion

In Jacowski v. Kraft Foods, et al., the Federal District Court for the Western District of Wisconsin denied plaintiff Kathy Jacowski‘s claim that Aetna arbitrarily and capriciously terminated her long-term disability benefits in violation of ERISA.
Jacowski began working for Kraft Foods in 1981. In 2008, Jacowksi quit her job, citing her poor mental health. Her treating physician diagnosed her with depression, anxiety, and post-traumatic-stress disorder. In 2011, she was notified by Aetna, the insurer that Kraft contracted with to administer its disability benefits, that she qualified for total disability benefits. She received these benefits until February, 2014, when they were terminated.
Continue Reading Aetna Defends Claim of Arbitrary and Capricious Disability Benefits Termination

The plaintiff in Neno v. Aetna Life Insurance Company, employed as a Senior Forensic Professional by a computer corporation, received short term disability benefits under his employer’s welfare benefit plan due to his debilitating neck and hip pain. After 24 months, those benefits were exhausted and his application for long term disability benefits was denied.
Continue Reading Court Allows Aetna to Use the Dictionary of Occupational Titles to Deny LTD Benefits

We have written on this subject before and the issue is one we get many questions on. Whether a disability insurance claimant must repay the insurance company for a retroactive social security award depends on the policy at issue and any subsequent agreements between the claimant and insurance company. Unfortunately, most ERISA governed long-term disability policies contain language giving the insurance company the right to recover any award of back benefits made by the Social Security Administration. Insurance companies often take it a step further by requiring claimants to sign “reimbursement agreements” by which the claimant promises to pay back any award of SSDI benefits that would result in an overpayment by the insurance company.
Continue Reading Court Rules Aetna Cannot Collect SSDI Overpayment

In the matter Thurber v. Aetna, Aetna brought a counterclaim against Thurber for the return of overpaid short-term disability benefits pursuant to ERISA 29 USC §1132 (a)(3), which authorizes civil actions brought to obtain appropriate equitable relief to enforce any provisions of this subchapter or the terms of the plan. Thurber had an auto accident and was receiving no fault insurance benefits and STD payment. Thurber’s STD policy stated that benefit paid by a n-fault auto insurance company would offset the STD benefit. Aetna paid the STD benefits and sought an overpayment for any funds paid by the auto insurance carrier.

Continue Reading Aetna is Entitled to Reimbursement of Overpaid Disability Insurance Benefits from Claimant Involved in Car Accident

Disability Blog & Cases:
Boeing Employee Suffering From Severe Chronic Back Pain Sues Aetna For Denial Of ERISA Benefits

An Oregon disability lawyer has filed a lawsuit in the District Court of Oregon against The Boeing Company Employee Benefit Plan (Boeing) and Aetna Life Insurance Company (Aetna). The Plaintiff, Susan A, worked as an assistant to the Vice President and General Counsel of The Boeing Company. Due to her employment, Plaintiff was protected by Boeing’s Employee Benefit Plan.


Disability Blog & Cases:
Unum Disability Denial With Medical Record Review Only

Can Unum deny disability claims and appeals by merely conducting paper reviews of a claimant’s medical records? Yes, apparently they can.


Disability Blog & Cases:
Sedgwick And AT&T Disability Denial Scheme Exposed In ERISA Lawsuit

On May 14, 2012, the U.S. District Court for the Northern District of California issued an order on a very hot topic for ERISA Disability Lawsuits. The issue concerns how much “Discovery” a denied person is able to obtain from the Disability Insurance Company while litigating a case.


FAQ: Appeals & Lawsuits:
If my long term disability benefits are governed by ERISA and I win at trial, does the insurance company have to pay me for the remainder of the policy life, or a lump sum amount?

Should your case go to trial under an ERISA governed disability plan and you win the insured is only entitled to an award of disability benefits that have not been paid by the insurance company. This is further contingent on whether the insurance company denied your claim under the “own occupation” or “any occupation” definition of disability…