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

An opinion issued by the United States District Court for the Middle District of Pennsylvania in November 2009 highlights the challenges an attorney faces when a complaint for denial of disability insurance benefits involves parties from different jurisdictions. An attorney must be very knowledgeable regarding insurance contract law in their state, because the laws of the state in which the contract is signed are the laws that will apply unless preempted by ERISA.

The case we are going to consider involves Edward J. Zaloga, a doctor of osteopathy. He filed his complaint originally in the Court of Common Pleas for Lackawanna County, Penn. in December 24, 2008. Because the claim exceeded the value of $75,000 and neither Provident Life & Accident Insurance Company (Provident Life) nor Unum Group (Unum) had corporate offices in Pennsylvania, jurisdiction over the case resided with the U.S. District Court.

→ Click here to continue reading Unum’s Attempts To Dismiss A Physician’s Bad Faith Disability Lawsuit Are Denied By Pennsylvania Federal Court

After 18 years of work as a management assistant at Raytheon Company, Dorothy Whitehouse suffered a psychotic episode in the workplace triggered by an experience with her boss and co-workers. The severity of the attack prompted her to immediately schedule an emergency appointment with her therapist, a licensed social worker on August 23, 2007.

→ Click here to continue reading Court Finds MetLife’s Denial Of Short-Term Disability Benefits Arbitrary And Capricious

Dr. C, a podiatrist / podiatric surgeon, was successfully practicing in Texas prior to the injury which caused his disability. During a routine blood draw, the phlebotomist taking Dr. C’s blood sample mistakenly injected the needle too deep into Dr. C’s right arm. Dr. C immediately felt shooting and burning pain radiating down his right arm and into his hand. In the weeks that followed, Dr. C experienced severe burning and tingling in his right arm. Dr. C consulted with a colleague in the hospital, a hand specialist, who explained that it was likely that the phlebotomist had injured his median nerve during the blood draw. The hand specialist advised Dr. C that if his symptoms did not resolve within a few weeks to come back and see him.

→ Click here to continue reading Attorneys Dell & Schaefer Files Lawsuit And Obtains Lump-Sum Buyout Of Disability Policy For Podiatrist With Median Nerve Injury

Dr. Z, a chiropractor, suffered an injury to both of his wrists while performing work in his backyard. As a result, Dr. Z was forced to discontinue his profession as a chiropractor and file disability claims under his three long-term disability insurance policies. Wanting to insure his financial future in the event that he became disabled, Dr. Z maintained three individual disability policies with three different insurance companies. Initially, the disability carriers approved Dr. Z’s claims and began paying him monthly disability benefits.

→ Click here to continue reading Attorneys Dell & Schaefer File Lawsuit And Obtain Lump-Sum Buyout For Chiropractor After Disability Carrier Denies Disability Benefits

Linda Chavis filed a complaint against Cigna Group Insurance and Life Insurance Company of North America (LINA) on June 24, 2009, alleging that the insurance company had breached two disability insurance contracts by refusing to pay her claims for short-term disability (STD) insurance and for long-term disability (LTD) insurance. While Cigna filed a motion to dismiss the complaint, Chavis stated in her complaint that she and her employer had paid all the required premiums for both policies, but she had been wrongfully denied benefits for both policies.

→ Click here to continue reading Court Finds CIGNA Failed To Follow Proper Claim Denial Procedure, Nurse’s Right To Pursue Disability Law Suit Under ERISA Supported

In a ruling filed on November 17, 2009, the United States Court of Appeals for the Eighth Circuit found that Prudential Insurance Company of America (Prudential) had failed to provide Barbara Brown adequate information with which to appeal their decision to deny her long term disability (LTD) benefits. As a result, the court did not apply a common court-approved practice which demands that all administrative options must be exhausted before filing suit.

→ Click here to continue reading Prudential’s Failure To Produce Documents Weighs In Long Term Disability Claimant’s Favor

The Third Circuit Court of Appeals recently rendered a very difficult decision in favor of Hartford Insurance Company dealing with the interpretation of pre-existing condition clauses in long-term disability income policies. The three judge panel ruled 2-1 in favor of upholding Hartford’s denial of disability benefits. The law in each state is different for pre-existing conditions, therefore a disability claimant should consult with a disability insurance attorney prior to filing a claim for benefits.

In the case we are going to consider here, Jay Doroshow v. Hartford Life and Accident Insurance Company, two judges found Hartford had been neither capricious nor arbitrary when the insurance company denied Doroshow’s claim for long-term unemployment. The third judge disagreed, arguing in his dissent that Doroshow had not received treatment for the condition that precipitated his claim with Hartford. We will have to look at the backdrop against which this case developed.

→ Click here to continue reading Third Circuit Court of Appeals Upholds Hartford’s Denial Of Long-Term Disability Claim Based on Pre-Existing Condition Defense

In a federal court in Peoria, Illinois, a jury ruled against Unum Company (NYSE: UNM)and awarded more than $300,000 in disability insurance benefits the insurer withheld from a general surgeon it had claimed was capable of conducting major surgeries, despite the surgeon’s difficulty standing for more than one hour at a time.

The eight-person jury, which included an employee from State Farm Insurance, headquartered nearby, ruled that Dr. Yogihn Parikh, who was a general surgeon at Hammond Henry Hospital in Genesco Il, was partially disabled, and as such was entitled to long-term disability benefits Unum had withheld under the disability insurance policy that Parikh purchased from them.

→ Click here to continue reading A General Surgeon And His Legal Team At Attorneys Dell & Schaefer Win Disability Insurance Jury Trial Against Unum

Our client was a litigator with his own successful practice. Early in 2009 he began to experience increasing pain in his upper back and neck. Thinking it was just a result of stress, he continued to try to work through the pain. As the pain worsened he sought medical treatment and later learned he had a life-threatening Chordoma in his cervical spine. The slow growing, highly dangerous Chordoma had to be removed, and in doing so would result in the fusion of multiple discs in his cervical spine and radiation treatment. In June of 2009 he underwent his surgery.

→ Click here to continue reading Berkshire Approves Total Disability Benefits For Litigation Attorney Following Multi-Level Fusion Of Cervical Spine And Surgery To Remove A Cancerous Tumor