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Case Summary Blog

Foss v. Standard – “Own Occ” Is With Any Employer, Not With Specific Employer

I’ve been away from case summaries for a bit. Going to turn that around with a recent decision in Foss v. Standard Insurance Company, Case No. 20-cv-2449, decided by the United States District Court for the District of Minnesota on August 19, 2022. Unfortunately, the Court ruled in favor of the insurance company. Plaintiff Caroline …

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Fowkes v. MetLife – Plaintiff Did Not Prove to Unum That She Was Disabled

Ms. Fowkes does not contend the Plan’s written evidence requirement violates ERISA. Instead, she takes issue with MetLife’s procedures to evaluate her LTD claim. In particular, she contends MetLife required her to present “objective evidence” supporting her LTD claim.

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Archer v. Hartford – Court Upholds Long-Term Disability Claim Denial

The claimant in Archer v. Hartford Life and Accident Insurance Company was an Assistant Store Manager at TJX Marshall’s Department Store. She had group Long Term Disability (LTD) coverage. She also had life insurance benefits. Both of these categories of group benefits were issued and administered by Hartford. Hartford had what we call “discretionary authority”. As claims administrator …

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Cassidy v. Aetna – Court Holds That There Is A Difference Between Diagnosis And Limitation

In Cassidy v. Aetna Life Insurance Company, the U.S. District Court for the Eastern District of Kentucky ruled in favor of Aetna in a Long Term Disability Insurance Claim. The decision was issued on May 21, 2021. The Long Term Disability Insurance claim was governed by the Employee Retirement Income Security Act of 1974 (ERISA). …

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Calkin v. USLIC – Court Finds Reasonable Basis For Long-Term Disability Claim Denial

Mr. Calkin was a 65-year-old manager of architectural design for AIG from June 10, 2013, through June 24, 2014. Mr. Calkin suffered from impingement syndrome in his left shoulder, brachial plexopathy (a form of neuropathy), bilateral shoulder pain, lower back pain due to degenerative disc disease and stenosis in his lumbar spine, degenerative joint disease in his left knee, as well as …

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Harrison v. LINA – Claim Denied Based On Pre-Existing Condition Exclusion

Ms. Harrison was a claimant who worked as a customer service representative for a cash advance lender. Her duties included selling financial products to customers, providing customer service, handling money, and overseeing financial transactions. She also suffered from depression and anxiety during her time at this place of employment. Ms. Harrison had suffered for many years from depression and …

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Senegal v. Reliance Standard – Court Remands Reliance LTD Claim For Further Review

In this case, Tommy W. Senegal (“Senegal”) had a long-term disability policy that was administered by Reliance Standard Life Insurance Company (“Reliance”) as a benefit of his employment by Cequel III, LLC (“Cequel”). Senegal worked for Cequel as a field service engineer; his duties were specifically related to supervising cable installation. This installation process involved …

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Donlick v. Standard – Standard Did Not Act In An Arbitrary And Capricious Manner

Marybeth M. Donlick (“Donlick”) was employed as a truck driver for Chesapeake Energy Corporation (“Chesapeake”). Through her employment, Donlick received coverage for a long term disability benefits plan, which was administered by Standard Insurance Company (“Standard”). On August 7, 2012, Donlick was in a motorcycle crash which caused her to have an amputation below her …

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Diaz v. Liberty Life – Court Upholds Liberty’s Long-Term Disability Denial

In this case, David Diaz (“Diaz”) was the district manager at JM Family Enterprises, Inc. (“JM Family Enterprises”) between September 2010 and October 2015. JM Family Enterprises’ had an employee benefit plan which covered long-term disability benefits. This plan was insured by Liberty Life Assurance Company of Boston (“Liberty”). Under the plan, the term “disabled” …

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Deroo v. Unum – Court Rules There’s No Suitable Job For Claimant

Carianne Deroo (“Deroo”) worked as an employee for Beaumont Hospital as a Clinical Nurse II. This role involved full-time work as a registered nurse which required patient care. Through her employment with Beaumont Hospital, Deroo was covered by a long-term disability benefits policy which was administered by Unum Life Insurance Company of America (“Unum”). The …

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