long term disability claim

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On June 19, 2008, the Supreme Court of the United States finally issued their opinion in the case of Wanda Glen v. Met Life. In a 6 to 3 decision announced Thursday, the US Supreme Court ruled that benefit denials by such companies must be examined with caution when circumstances suggest a high likelihood that financial considerations affected a benefits decision.
Continue Reading US Supreme Court Attempts To Clarify The Standard Of Review In Denial Of Long-term Disability Benefits

Daniel J. Rochow, the former president of Arthur J. Gallagher & Co., was insured under Life Insurance Co. of North America’s disability plan. The Sixth Circuit affirmed that a disability insurer’s denial of benefits to a former employee who was terminated because his symptoms prevented him from performing his duties was arbitrary and capricious, even though the employee’s diagnosis was not made until after he stopped working.
Continue Reading Diagnosis of Insured’s Medical Condition After Termination of Employment Does Not Preclude Disability Claim

Carol Shepherd, a fork-lift operator for Daramic, was insured under the company’s group disability plan with Reliance Standard Life Insurance Company. In 2004, Ms. Shepherd had an anxiety attack at work and Daramic suspended her and required that she participate in anger management before returning to work.
Continue Reading Court Upheld Standard’s Decision to Deny Disability Benefits

Jenny Eberle, an employee of Purdue University, was initially approved for long-term disability benefits by the Prudential Insurance Company of America. Shortly after her claim was approved, a new claims examiner and registered nurse reviewed Ms. Eberle’s medical records and decided to terminate her long term benefits in November 2004.
Continue Reading Prudential’s Motion to Dismiss Claimant’s Disability Benefits is Denied

Larry Mack claimed that he is totally disabled from his occupation as a marriage and family therapist due to diabetes. He sued his disability insurer, Unum Life Insurance Company, after being denied his claim for long-term disability benefits.
Continue Reading Insured Denied Benefits by Unum Due to Failure to Receive “Appropriate Care”

Kelly Iley, a pharmacist for Kroger Co, was insured under the company’s group long-term disability policy with Metropolitan Life Insurance Company (MetLife). In June 2001, Ms. Iley was diagnosed with lumbar disc disease.
Continue Reading MetLife Denial Reversed on Appeal: A Diagnosis of Radiculopathy is Exempt from 24 Month Limitation Period for Neuromusculoskeletal Disorders

Robin Plummer, a pharmacist for Kmart Corporation, was insured under the company’s group disability plan administered by Continental Insurance Company. In 2003, Hartford Life Insurance Company took over administration of the plan.
Continue Reading Hartford’s Attempt to Deny Disability Benefits Based on Video Surveillance is Reversed on Appeal

Nancy Mikrut, a pediatric nurse practitioner for Danbury Health Systems, was insured under the company’s group disability plan administered by Unum Life Insurance Company of America. In 1999, Ms. Mikrut was injured in an automobile accident and was unable to return to work due to severe back pain.
Continue Reading Unum’s Denial of Pediatric Nurse is Overturned on Appeal