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?

The Standard Insurance Company sells multiple different long-term disability policies to dentist and other medical professionals. The difference in each policy is usually the definition of disability. In my opinion, the following definition of Own Occupation Disability sold by Standard is called an Own Occupation definition, but it is not a true Own Occupation policy. The following definition of Own Occupation is misleading and essentially requires the policy holder to be unable to work in any occupation.

Our law firm has represented numerous claimants that have purchased a long-term disability policy from Standard with the following definition of Own Occupation…

→ Continue reading Dentist and doctors: beware of the Standard Insurance Company Group’s long-term disability policy

In the case we are going to look at, a disability insurance attorney found himself representing a client who believed that Metropolitan Life Insurance Company (MetLife) had wrongfully denied the extension of his long-term disability benefits.  This is a far too common occurrence, and one that disability insurance attorneys see frequently. As we look at this case, you will see that without the representation of a disability attorney, John Lanier would not have received his rightful benefits.

→ Continue reading MetLife denies long-term disability benefits to a consultant after approving them

Once again, long-term disability insurance provider Metropolitan Life Insurance Company (MetLife) has been ordered by the court to reverse a long-term disability denial because the Court found the grounds for denying the benefits were arbitrary and capricious. This is a far too common occurrence, and one that disability insurance attorneys see frequently.

We are going to look at how Lanier’s disability insurance attorney represented him before Judge David M. Lawson of the U.S. District Court, Eastern District of Michigan, Southern division.

→ Continue reading MetLife ordered to reverse denial of long-term disability insurance benefits

This is a case in which Unum’s decisions to deny benefits was consistent with the policy language. Employer-provided group disability insurance plans are different from individual plans. An employer-provided disability plan depends upon the employer/employee relationship. If something happens to interrupt this employer/employee connection it can have consequences, as Carol Jones discovered.

→ Continue reading Unum denies disability benefits to a Minnesota legal secretary with pre-existing condition

Attorneys Seek Information In Order to Prove Conflict of Interest Impacted Claim Denial

Another case appeared recently before the United States District Court, Northern District of Indiana, Hammond Division. It sheds light on motions to compel. We will look at the background behind the motion before looking at how the Court evaluated the need for discovery into a disability insurance company’s claims decision process. This case is another example of how a disability insurance company will fight with great effort to hide their potentially unreasonable claims handling activities.

BP Corporation of North America employed Clifford Hall for 27 years as a process operator. On December 1, 2007 he was involved in the motor vehicle accident that caused serious neck and back injuries and a traumatic brain injury as well. He worked his last day at BP the next day.

→ Continue reading Life Insurance Company of North America (CIGNA) ordered to supply information to disability insurance attorneys

The case we will look at here demonstrates once again how reviewing a disability denial under the abuse of discretion standard can favor an insurance company’s disability denial. All the insurance company must prove is that the process used to come to a claims decision was logical and reasonable. As you read the following case, it might seem that Jerry Darvell and his disability insurance attorney had good reason to believe he had been denied benefits wrongfully. You will discover why two federal courts decided otherwise.

→ Click here to continue reading LINA (CIGNA) denies long-term disability benefits to yellowbook Account Executive

This case is a sad example of how a disability claimant can battle a disability insurance company in an ERISA lawsuit for several years and then have a Judge give the insurance company another opportunity to wrongfully deny disability benefits. 

As an employee of Philips Lighting Company, 55-year-old Ronald E. Cox had been a repairman and tradesworker for nearly 24 years. While he had earned his GED, he had never graduated from high school. His job’s duties included installing, repairing, constructing and maintaining plant facilities and equipment. He fabricated and installed frames and supports for the tanks, kilns and other equipment in the plant facilities.

→ Click here to continue reading Life Insurance Company Of North America (CIGNA) wrongfully denies disability benefits to a Kentucky repairman

Dalit Waissman took sued Life Insurance Company of North America (LINA) when the company terminated her long-term disability payments in May 2006. In arguments presented before District Judge Jeremy Fogel of the U.S. District Court’s Northern District of California, San Jose Division on January 20, 2010, Waissman’s disability attorney did his best to show that the material in Waissman’s claim’s file demonstrated beyond doubt that Waissman was disabled according to the definitions laid out within her former employer’s long-term disability plan.

→ Click here to continue reading Did LINA wrongfully deny disability payments to claimant with multiple sclerosis? (Part II)

Dalit Waissman, a 53 year old who immigrated to the United States from Israel in 1984, came to her position at SAP, Inc. in 1997 with considerable experience in computer programming and educational consultation and resource coaching. She had spent the previous two years working as an independent contractor providing technical writing services.

SAP hired Waissman as one of their Senior Technical writers. The primary duties of her job according to SAP were to provide “excellent research, interviewing and writing skills: information mapping skills; instructional design skills; knowledge of the business cycles; knowledge of computer software, Windows applications and authoring tools; and HTML/Internet knowledge.”

→ Click here to continue reading CIGNA (LINA) terminates disability payments to woman with multiple sclerosis