Court in ERISA appeal finds classic LTD disability insurer cherry-picking Disability insurers have an arsenal of tactics to deny or terminate disability benefit claims. One common tactic is “cherry-picking” in which the insurer or its claims administrator picks...
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ERISA
Long-term disability policy interpretation under ERISA
A federal court in Texas recently found in favor of a long-term disability (LTD) claimant whose insurer had terminated his benefits. The March 10 opinion illustrates federal rules for interpreting disability insurance policies. In Chavez v. Standard Insurance Co., the...
Traumatic Brain Injury LINA Claim Denial Reversed and found to be Arbitrary and Capricious
In the case of Van Steen v. Life Insurance Company of North America ,WL 256806 (10th Cir. Jan. 2, 2018) the Tenth Circuit, affirmed the district court's decision, finding that Life Insurance Company of North America's decision to terminate Mr. Van Steen's benefits was...
Federal District Court Finds that Hartford Failed to Provide a Claimant with a Full and Fair Review of her ERISA Governed Disability Insurance Claim.
In a recent case out of the Southern District of Indiana, Miller v. The Hartford Life And Accident Insurance Co., & Springleaf Finance, Inc. Disability Plan, No. 116CV00166TWPDML, 2017 WL 2214938 (S.D. Ind. May 19, 2017), the federal court found that Hartford...
Reliance Standard Life Insurance Company Denial Tactics Dismissed By Court in ERISA Disability Case
Most individuals who have filed any type of insurance related claim have experienced the delay and denial tactics used by their insurance company to avoid payment. Disability carriers often take extreme and arguably egregious measures to "prove" that a claimant is not...
Seventh Circuit Upholds District Court’s Decision that a Claimant with Fibromyalgia was Disabled under her ERISA Governed Disability Plan and Commented on the Disabling Nature of Fibromyalgia.
In a recent case, Kennedy v. The Lilly Extended Disability Plan, No. 16-2314, __F.3d__, 2017 WL 2178091 (7th Cir. May 18, 2017), the Seventh Circuit Court, overturned a disability insurance benefit denial of a claimant with fibromyalgia. The claimant in the Kennedy...
The Fifth Circuit Court of Appeals Calls into Question Whether Deference Should be Given to the Factual Benefit Determinations of ERISA Plan Administrators.
In a recent decision, Ariana M v. Humana Health Plan of Texas, Inc., 2017 WL 1423765 (5th Cir. April 21, 2017), the Fifth Circuit Court of Appeals called into question the validity of its holding in Pierre v. Connecticut General Life Insurance Co./Life Insurance Co....
Court Overturns Northwestern Mutual’s Denial of Disability Insurance Benefits to Attorney With Congestive Heart Failure Unable to Handle Stress
A federal district court recently overturned Northwestern Mutual's denial of own occupation disability insurance benefits to an attorney with congestive heart failure unable to handle stress. The case Mustain-Wood v. Northwestern Mututal Life Insurance Company...
U.S. Supreme Court Limits Time for Filing a Lawsuit in ERISA Disability Insurance Claims
Typically, a statute of limitations-or the state mandated time period within which a claimant must file a lawsuit-begins to run once a cause of action arises. In ERISA disability claims, the cause of action arises and claimants are not permitted to file a lawsuit...
The things the insurance company may not tell claimants about their rights under ERISA
There are many things that an administrator or insurance company may not tell claimants about their rights in ERISA benefit claims and ERISA appeals (when there has been a denial of their ERISA benefits). Just a few of the many things that the insurance company may...