When Laurie Cooper walked into the U.S. Court of Appeals, 5th Circuit, in New Orleans, she had to demonstrate before the court that she had been denied a full and fair review of her claim and that the denial of her benefits abused the discretion given the benefit provider, Hewlett Packard Company Disability Plan. Two out of three judges found that she had failed to do this. In a two-to-one decision, the ruling from the U.S. District Court for the Southern District of Texas was affirmed.

The end result? Ms. Cooper will not receive long-term disability benefits. Let’s look at this case and see how the circuit judges reached their conclusions.

→ Click here to continue reading Hewlett Packard’s denial of disability benefits is upheld by appeals court

Another case highlights the importance of making timely appeals when your long-term disability benefits are denied. Richard MacLennan discovered this when he took his case to court against Provident Life And Accident Insurance Company (Provident).

MacLennan filed his case in the U.S. District Court, District of Connecticut. In his claim, MacLennan sought to take advantage of tolling, a legal doctrine that allows for a statute of limitation to be extended. "Equitable tolling" can delay the initiation of a statute of limitations or it can halt the countdown of time after it has started.

→ Click here to continue reading Long-term disability claim against Provident almost lost because of untimely appeals

When Judge Stephen V. Wilson delivered his decision on January 13, 2010, it probably resulted in some mixed feelings for Kelly Lavino. She had hoped for a clear victory in her battle with Metropolitan Life Insurance Company (MetLIfe) to have her long-term disability benefits restored. Instead the judge rendered a decision that may put her at the insurance company’s mercy once again.

Lavino had been a project engineer for Malcolm Pitnie, Inc. One of the benefits of employment included coverage under a short-term and long-term disability plan issued by MetLife. This entitled Lavino, if she became and remained disabled, to long-term disability benefits.

→ Continue reading MetLife abused its discretion when it terminated long-term disability benefits

January 13, 2010 was a good day for Kelly Lavino. U.S. District Court, Central District of California Judge  Stephen V. Wilson ruled that Metropolitan Life Insurance Company (MetLife) wrongfully denied disability benefits and abused its discretion when it decided to terminate Lavino’s long-term disability benefits. Let’s review what Judge Wilson considered as he made his decision.

→ Click here to continue reading MetLife terminates long-term disability benefits to woman with fibromyalagia

Verla Hancock participated in a group benefit plan sponsored by her employer, Intermountain Healthcare. The plan’s claim fiduciary was Metropolitan Life Insurance Co. (MetLife). Under the plan, Verla obtained basic life insurance, supplemental life insurance and accidental death and dismemberment coverage (AD & D).

The plan stipulated that in order to benefit from the AD & D coverage, the policy holder had to be 1) Injured in an accident; 2) The accident had to be the sole cause of injury; 3) The accident had to be the sole cause of death; 4) The death had to occur within 365 days of the accident. The District Court found that policy beneficiary Terri Hancock had failed to demonstrate that she had a claim against MetLife for accidental death and dismemberment in her mother’s death.

Would Terri Hancock’s appeal be successful? Let’s look at the facts surrounding Verla Hancock’s death.

→ Click here to continue reading 10th Circuit Court of Appeals validates MetLife’s accidental death and dismemberment denial

Ronnie Hogan sued Provident Life & Accident Insurance Company (Provident) and Unum Group Corp. (Unum) asserting claims under Florida law that the insurance companies had failed to attempt in good faith to settle his claim. Hogan also accused the insurance companies of making misrepresentations that would have made a settlement less favorable for him. He accused them of exercising general business practices that involved mishandling claims, breaching their fiduciary duty, common law fraud, negligence and even conspiracy to commit statutory violations. Provident and Unum asked the judge to dismiss Hogan’s case based on a failure to state his claim or at least to pass judgment based on the pleadings presented by the two sides.

→ Click here to continue reading Unum’s claim handling exposes them to a multi-million dollar bad faith disability lawsuit

Lynda Sacks worked as a mortgage loan underwriter for Countrywide Home Loans, Inc. Her employer offered both short-term and long-term disability plans issued by Standard Insurance Company (Standard) effective January 1, 2005. Standard was responsible for funding both disability plans and making the claims determinations.

→ Click here to continue reading Standard Insurance denies disability claim to a wheelchair bound woman

After Hans-Gerd Rasenack was struck by a hit-and-run driver he applied for benefits under the accidental death and dismemberment insurance he paid for through employee deductions. The policy was issued through AIG Life insurance Company (AIG) and administered by AIG Claim Services. The policy provided an accidental paralysis benefit which covered hemiplegia.

At issue before the U.S. Court of Appeals for the Tenth Circuit was the decision of the U.S. District Court for the District of Colorado. The matter before the court arose under the Employee Retirement Income Security Act (ERISA) which lays out the procedures the court must follow in evaluating a case.

→ Click here to continue reading Accidental death & disability dismemberment; AIG reversed by Colorado Court

Our client, a general surgeon with chronic back pain, will finally receive the long-term disability benefits that he has been denied since October 2004. The United States District Court for the Central District of Illinois entered a final judgment of $402,268.00 against UNUM (formerly known as Paul Revere Life Insurance Company).  In addition to the $402,000 our client’s disability policy will pay him more than $3.9 million over his lifetime.

→ Click here to continue reading $4.3 million in disability benefits for general surgeon following UNUM jury verdict

Disability Attorneys Dell & Schaefer win a long-term disability appeal on behalf of a psychologist whose disability benefits were denied by Liberty Mutual. Our client’s benefits were re-instated and she will now receive several hundred thousands of dollars throughout her lifetime. 

→ Click here to continue reading Liberty Mutual reverses decision to terminate disability benefits