Disability Insurance Cases Nationwide

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In Vicki Young v. Sun Life and Health Insurance Company, plaintiff Young, a mortgage broker, was initially granted disability benefits in September 2010 based on her diagnosis of fibromyalgia. The initial two years of her disability were based on her inability to perform the essentially duties of her own occupation.

After two years, Sun Life continued her long term disability (LTD) benefits on the grounds that she did not have the ability to perform the job duties of any occupation for which she was qualified. Suddenly, in 2015, Sun Life terminated her benefits, stating she was no longer disabled under the “any occupation” standard. Young’s administrative appeal was denied and she filed this ERISA lawsuit in the U.S. District Court for the Eastern District of California.Continue Reading Court Reinstates Disability Benefits Erroneously Terminated by Sun Life

In Riley v. MetLife, a case decided in March 2014 in the United States Court of Appeal for the First Circuit, Plaintiff Riley first made a claim for LTD benefits in 2000 when he was employed as an associate general manager. He received LTD benefits, but returned to work in 2001 in a non-managerial position where he earned substantially less. In 2002, Riley left work once again and made another claim for LTD benefits. Riley’s LTD claim was eventually approved in 2005, and he received his first LTD benefit check in April of 2005 for an amount based on his non-managerial salary, which was substantially less than he would have received based on his managerial salary. Since Riley disputed the amount of his lower LTD benefits based on his non-managerial salary, he refused to cash the checks and threatened to file suit.
Continue Reading If You Are Aware of an Underpayment or Miscalculation of Your LTD Benefits Don’t Wait to Hire an Attorney because Your Time to File a Lawsuit May be Running Out

In Micha v. Sun Life Assurance Company of Canada and Group Disability Benefits Plan (Sun Life v. Group Disability), plaintiff John Paul Micha, M.D., was covered by a disability benefit policy through Sun Life which had been purchased by Group Disability, an employee welfare plan maintained to provide disability benefits to the employees of the medical group of which Micha was a part.
Continue Reading Court Orders Sun Life Assurance Company to Pay Appellate Attorney’s Fees

Disability Insurance News:
Colorado District Court overturns denial of benefits by Life Insurance Company of North America
Court finds LINA’s challenge on claimant’s credibility unfounded.

Disability Insurance News:
Court Remands Finding That Reliance Arbitrarily Denied Disability Benefits
Kansas Court remands after finding Reliance Standard Life acted arbitrarily and capriciously in denying plaintiff long term disability…

In this video, Attorneys Gregory Dell and Rachel Alters discuss a recent court decision in which Principal Life attempted to ignore an income qualifier in an “any occupation” definition as a technique to deny benefits. The court determined the policy language to be ambiguous and provided an interpretation in favor of the claimant. If you…

Disability Insurance News:
Principal Life Disability Denial of Truck Driver Reversed by Washington Federal Judge
Principal Life Insurance long term disability benefit denial is ruled unreasonable by a Washington Federal Judge.

Resolved Cases:
Another Palm Beach County Sheriff’s Deputy’s Long Term Disability Claim is Reinstated Following Appeal by Disability Attorney Alexander Palamara
Sheriff’s Deputy suffering…

In this video, Attorneys Gregory Dell & Rachel Alters discuss a recent court ruling in which Reliance Standard failed to reasonably evaluate the cognitive aspects of the plaintiff’s requirements to do her job as an attorney. Unfortunately for the policy holder, the court remanded the claim back to Reliance Standard for further evaluation of benefits.
Continue Reading Reliance Standard Denial of Disability Benefits for an Attorney Reversed by Kansas Judge

Prior to her disability Hadar Meiri was Vice President, Human Experience Strategy Director for MediaVest USA, earning an annual salary of $165,000. In July 2014 she was diagnosed with thyroid cancer for which she underwent a total thyroidectomy. She had also had a history of Hashimoto’s Thyroditis and Hypothroidism. Following her surgery she continued experiencing fatigue and weakness. She also developed symptoms of brain fog, poor memory, fatigue, and poor focus.
Continue Reading US District Court Judge Orders Hartford Life and Accident Insurance Company to Pay Long-term Disability Benefits to Disabled Executive After It Denied Thyroid Cancer Claim

As we have indicated time and time again, an ERISA administrative appeal is one of the most important documents to be filed as part of your disability insurance claim. Second only to the initial application for benefits, your administrative appeal is often your only opportunity to provide evidence of disability sufficient for an insurance carrier to overturn a denial of benefits. Although some insurance carriers such as Lincoln require a mandatory second appeal and others such as Prudential and Cigna allow for voluntary second appeals, the vast majority of insurance carriers only allow for one level of appeal and if that is denied the only recourse available is to file a lawsuit under ERISA. We have explained the perils of litigating an ERISA based disability policy on many occasions on our website, as such, in this article so we will not go into the Arbitrary and Capricious standard of review commonly applied in ERISA cases. However, it is important to note that in a lawsuit brought under ERISA there are no jury trials nor is there live testimony at “trial,” which means neither you as the insured or your doctors will be allowed to testify before the judge, and last, relevant to this article- no new information after the final denial of benefits will be allowed at trial. With this final caveat, it becomes all the clearer why filing as complete an Appeal as possible is crucial to receiving your disability benefits.
Continue Reading Court Rejects New Information in ERISA Disability Case