One of the hardest things I must explain to clients is how the insurance company does not care about the client’s disabling condition. Disability insurance companies are for-profit corporations constantly seeking ways to increase their bottom lines. More often than not, they accomplish this by denying long-term disability claims. In this article, we discuss an insurance …
Wittman v. Unum – LTD Denial Was Not Arbitrary And Capricious
Anne Wittmann (“Wittmann”) was an attorney at Baker, Donelson, Bearman, Caldwell, Berkowitz PC (“Baker Donelson”). Unum Life Insurance Company of America (“Unum”) administered and underwrote the long term disability (LTD) plan that covered Wittmann. Wittmann filed a claim for disability benefits on April 7, 2014, since she had not worked from December 31, 2013. Under the …
Wittman v. Unum – LTD Denial Was Not Arbitrary And CapriciousRead More
Bigham v. Liberty Life – In De Novo Review Court Should Conduct Bench Trial On The Record
Case Name: Rose Bigham v. Liberty Life Assurance Company of Boston Court: United States District Court for the Western District of Washington at Seattle Type of Claim: Long-Term Disability Insurance Company: Liberty Life Assurance Company of Boston a/k/a Liberty Mutual Insurance Company (hereinafter “Liberty Life”) Claimant’s Employer: Amazon, LLC Claimant’s Occupation / Job Position: Security Technical Program Manager Disabilities: chronic intractable pain, fibromyalgia, …
Bigham v. Liberty Life – In De Novo Review Court Should Conduct Bench Trial On The RecordRead More
Williams v. Standard – Court Upholds Plan Administrator’s Decision
Defendant advances two grounds for terminating the plaintiff’s long-term disability benefits. First, the defendant contends the plaintiff does not qualify for an exception to the “Other Limited Conditions” provision under the Plan because he does not have a herniated disc with documented neurological abnormalities. Second, the defendant claims the plaintiff is not disabled from all occupations and thus does not qualify for benefits during his policy’s “Any Occupation” period. If established, either of these grounds would provide a recognized justification for the termination of the plaintiff’s benefits under the terms of the Plan.
Williams v. Standard – Court Upholds Plan Administrator’s DecisionRead More
Wilkinson v. Sun Life – Sun Life Abused Its Discretion By Denying Benefits
The Fourth Circuit held that Sun Life abused its discretion when it terminated Wilkinson’s benefits because he provided sufficient evidence to support his eligibility for coverage and because Sun Life’s decision to terminate benefits was not the result of a principled reasoning process and not supported by substantial evidence. The Fourth Circuit, therefore, affirmed the district court’s decision.
Wilkinson v. Sun Life – Sun Life Abused Its Discretion By Denying BenefitsRead More
Till v. Lincoln – Claimant Failed To Provide Adequate Documentation To Support Claim
Lincoln denied the Plaintiff’s LTD claim. The plaintiff filed a lawsuit in Federal Court. Lincoln filed a motion for judgment as a matter of law, to which Till responded with a motion for summary judgment. After a full briefing, the district court entered an order granting Lincoln’s motion and denying Till’s. The district court also subsequently denied Till’s motion to reconsider. After carefully considering the record on appeal, the parties’ briefs, and the relevant law, the Eleventh Circuit concluded that the district court decision is due to be affirmed.
Till v. Lincoln – Claimant Failed To Provide Adequate Documentation To Support ClaimRead More
Smith v. Reliance – Reliance Committed An Abuse Of Discretion
In this case, Fredrick Smith (“Smith”) was employed as a plant manager for Charles Craft, Inc. (“Craft”) reaching back to the 1970’s. Through his job, he held group policies with Reliance Standard Life Insurance Company (“Reliance”). Two of these polices included a long term disability benefits plan and a life insurance policy. If an employee is considered …
Smith v. Reliance – Reliance Committed An Abuse Of DiscretionRead More
Mayer v. Mercy And LINA – Court Unable To Determine Whether Plan Is Church Plan Or Not
Ursula Mayer (“Mayer”) was an employee of Mercy Health Services, LLC (“Mercy”) and was covered under a long-term disability insurance policy that was issued by Cigna Group Insurance (“Cigna”). She claimed that she was totally disabled according to the definition within the policy, that she applied for benefits with Cigna, and that her claim was denied. …
Mayer v. Mercy And LINA – Court Unable To Determine Whether Plan Is Church Plan Or NotRead More
Tash v. MetLife – Court Holds That MetLife Undermined The ERISA Process
The Court held that MetLife undermined the ERISA process by failing to issue a proper denial and, further, by failing to notify the insured about the issues in dispute. The Court ordered MetLife to pay past-due benefits, with interest, and to continue paying benefits so long as they continue to remain due under the provisions of the Plan, unless and until MetLife issues a denial that is in full compliance with the requirements contained in ERISA.
Tash v. MetLife – Court Holds That MetLife Undermined The ERISA ProcessRead More
Slaton v. Standard – Claimant’s Failure To Report Symptoms Led To Claim Denial
The Court concluded that Defendant did not act in an arbitrary and capricious manner in denying Plaintiff’s claim for long-term disability benefits. Accordingly, the Court overruled Plaintiff’s Motion for Judgment on the Administrative Record, and sustained Defendant’s Motion for Entry of Judgment on the Administrative Record.
Slaton v. Standard – Claimant’s Failure To Report Symptoms Led To Claim DenialRead More