Aetna

Case Name:  Gregory Cannon v. Aetna Life Insurance Company Court: United States District Court for the District of Massachusetts Type of Claim: Long-Term Disability Insurance Company: Aetna Life Insurance Company (hereinafter “Aetna”) Claimant’s Employer: PharMerica Corp Claimant’s Occupation / Job Position: Pharmacist Disabilities: Gastroparesis, syncope, and working diagnoses of paroxysmal atrial fibrillation, Lyme disease, Parkinson’s disease and …

Cannon v. Aetna – Aetna Not Bound By SSA Disability DeterminationRead More

Plaintiff appealed the initial denial of benefits under the Plan, stating that her request for disability was not based solely on her thyroid surgery but rather on symptoms associated with lupus and chronic pain. On September 12, 2011, ALIC again upheld the denial of benefits to the Plaintiff. As allowed under ERISA, the Plaintiff sued to challenge that decision. Both parties moved for judgment on the administrative record.

Gaines v. Aetna – Court Rules Aetna Refused To Credit Reliable EvidenceRead More

Plaintiff Laverne Robinson brought a lawsuit against Aetna Life Insurance Company (“Aetna”) and Mondelez Global LLC Employee-Paid Group Benefits Plan (“the Plan”) for unpaid long-term disability (“LTD”) benefits under the Employee Retirement Income Security Act of 1974 (“ERISA”). Robinson was a former utility machine operator for Mondelez. As an employee, she could receive disability benefits under the Plan. Aetna served …

Robinson v. Aetna – Claim Sent Back To Insurer To Assess Disability Under Plan’s “Any Occupation” DefinitionRead More

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). …

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

In Mozdzierz v. Aetna Life Insurance Company, the plaintiff (claimant) seeks long term disability benefits from Aetna, the insurer of his ERISA-governed long term disability plan. The Federal District Court (for the Eastern District of Pennsylvania) found that Aetna did not abuse its discretion in denying plaintiff’s claim based upon the record. In other words, Aetna’s denial of benefits was upheld. …

Mozdziers v. Aetna – Video Surveillance May Offer Significant Support For Denying LTD ClaimsRead More

The Court granted Plaintiff’s Motion for Summary Judgment: “As explained above, I have identified three primary reasons for determining that Aetna abused its discretion in denying Plaintiff’s benefits: Inappropriate reliance on unreliable findings by Drs. Topper, McPhee, and Polanco; failure to address Plaintiff’s qualifications and ability to engage in sedentary occupations in light of her medication requirements; and failure to address the findings in the APS and Capabilities and Limitations Worksheets showing that Plaintiff could not perform full-time sedentary work.

Young v. Aetna – Aetna Commits Abuse Of Discretion In Denying Plaintiff’s LTD ClaimRead More

The present case involves an appeal by Aetna Life Insurance Company (“Aetna”) from a successful motion for summary judgment granted in Christopher Patterson’s (“Patterson”) favor. Regarding the same case, the court had also denied a motion for summary judgment filed by Aetna. Patterson was covered under a long-term disability policy by Aetna through his employer Fire Consulting Group, …

Patterson v. Aetna – Court Rules Own Occupation And Regular Occupation Are InterchangeableRead More

The medical evidence available does not suggest that Aetna abused its discretion by determining that Neno is able to perform the “material duties” of his “own occupation” as defined under the employee welfare benefit plan. Aetna’s decision was supported by substantial evidence and was made with deliberate and principled reasoning, as it reviewed Neno’s medical records and sought opinions from independent sources.

Neno v. Aetna – Court Finds There Was No Abuse Of DiscretionRead More

When considering the record as a whole, the Court finds that Aetna’s denial of LTD benefits to Murphy was supported by substantial evidence therein and that Murphy has not met her burden to establish that such denial was arbitrary and capricious. Accordingly, Murphy’s objections to Aetna’s denial cannot withstand Aetna’s motion for summary judgment.

Murphy v. Aetna – Claim Terminated Under The Any Occupation StandardRead More

Under the arbitrary and capricious standard, the review is limited to whether reasonable grounds existed to support Aetna’s denial of benefits based on the administrative record before it. The Court held that Aetna reasonably concluded that Plaintiff was no longer entitled to long-term disability benefits and that their decision process was neither arbitrary nor capricious. Aetna’s denial of continued long-term disability benefits was affirmed.

Mercado v. Aetna – Court Rules Aetna’s LTD Claim Denial Was ReasonableRead More