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Denial of Benefits Long Term Disability Insurance

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - August 2024

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This month’s Friday Five explores decisions from around the country discussing differences between the scope of discovery and ability to add documents to the record on a claim for review challenging the denial of LTD...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - April 2024

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This month’s Friday Five covers the treatment of job-related stress in assessing an attorney’s disability, the requirements surrounding the qualifications of a medical professional to review a claimant’s medical records in...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - March 2024

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This month’s Friday Five covers cases relating to an alleged conflict of interest leading to discovery, two courts’ opposite treatments of subjective pain complaints, a decision that claims of fraud and misrepresentation were...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - February 2024

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This month’s Friday Five explores decisions regarding the transfer of an ERISA action that was filed in a state where an insurer did not maintain sufficient minimum contacts, an award of attorneys’ fees, costs, and...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - January 2024

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On Halloween, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $100,000 settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Doctors’...more

Seyfarth Shaw LLP

Ninth Circuit Clarifies De Novo Review Standard and Newly-Raised Arguments in ERISA Litigation

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Recently, the Ninth Circuit addressed and further clarified the requirement of a “full and fair review” in the context of a long-term disability benefit case under the Employee Retirement Income Security Act (ERISA). In...more

Proskauer - Employee Benefits & Executive...

Second Circuit Decision Illustrates Importance of Following Claims Procedures, and Drastic Consequences of Procedural Misstep

In McQuillin v. Hartford Life and Accident Ins. Co., 36 F.4th 416 (2d Cir. 2022), the U.S Court of Appeals for the Second Circuit restored a claimant’s action for disability benefits due to the plan administrator’s failure to...more

Jackson Lewis P.C.

Eighth Circuit: District Court Improperly Resolved Factual Disputes on Summary Judgment in ERISA Benefits Case, But Error Harmless

Jackson Lewis P.C. on

In Avenoso v. Reliance Standard Life Insurance Company, No. 21-1772, 2021 U.S. App. LEXIS 35264 (8th Cir. Nov. 30, 2021), the Eighth Circuit clarified its position in a circuit split over the proper judicial procedure for...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: District Court Finds Reduction in Monthly LTD Benefit Due to IRA Rollover Appropriate Under Plan Terms

In DeBold v. Liberty Life Assur. Co. of Bos., 2021 U.S. Dist. LEXIS 120153 (D. Mass, June 28, 2021), a district court held that an ERISA plan administrator could reduce an insured's monthly long-term disability (LTD) benefit...more

Littler

Disability Benefits Policy Language Warrants Arbitrary and Capricious Standard of Review Despite Enactment of Anti-Discretionary...

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A federal court in New Jersey recently applied the arbitrary and capricious standard of review for a denial of benefits claim despite the enactment of an anti-discretionary statute in Minnesota, which governed the benefit...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor - October 2020: District Court Holds Breach of Contract Claims are Time-Barred

Plaintiff Gene Myers (“Plaintiff”), a physician, made a claim for individual disability insurance (IDI) benefits under an individual disability policy arising from low back injury caused by wearing a heavy leaded gown worn...more

Carlton Fields

ERISA Disability Plan Insurers Score Important Circuit Court Victories

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In recent months, circuit courts across the country have supported insurers’ discretion to deny long-term disability benefits (LTD) under ERISA. Since the beginning of the year, disability plan insurers have prevailed in the...more

Morrison & Foerster LLP - Left Coast Appeals

This Week at The Ninth: Employees, Independent Contractors, and ERISA

This week, this Ninth Circuit once again issued a number of opinions arising from the employment relationship. Here, we focus on two of particular interest. In the first, the Court sought to unravel whether an emergency room...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Court Applies "Reasoned Approach" in Upholding Insurer's Denial of LTD Claim

In Creed v. Hartford Life & Acc. Ins. Co., 2020 U.S. Dist. LEXIS 17613, (S.D. Ohio February 4, 2020), the court applied a "reasoned explanation" approach to hold that the evidence supported an insurer's decision to deny an...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Eleventh Circuit Rules Against Insurer in LTD Case

In Kaviani v. Reliance Std. Life Ins. Co., 2020 U.S. App. LEXIS 3006 (11th Cir. Jan. 31, 2020), the Eleventh Circuit held that an insurer had failed to give sufficient credence to a claimant's self-reports of pain and...more

Hinshaw & Culbertson - The LHD/ERISA Advisor

The LHD/ERISA Advisor: Ninth Circuit Affirms Judgment for Unum Life In ERISA Disability Benefits Case

In Western v. Unum Life Insurance Company of America, 798 F.App'x 154, 2020 U.S. App. LEXIS 8362 (9th Cir. March 17, 2020), the Ninth Circuit affirmed Unum Life's determination that an aerospace engineer diagnosed with...more

Rivkin Radler LLP

Employee Benefit Plan Review – From the Courts

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Ninth Circuit Affirms Decision Rejecting Suit Seeking Early Retirement Benefits - The U.S. Court of Appeals for the Ninth Circuit has affirmed a district court’s decision rejecting a plaintiff’s lawsuit seeking to overturn...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: First Circuit Clarifies ERISA's Timing Requirements for Appealing Adverse Benefits Determination

In Fortier v. Hartford Life & Accident Ins. Co., 916 F.3d 74 (1st Cir. 2019) the U.S. Court of Appeals for the First Circuit clarified ERISA's timing requirements with respect to appealing an adverse benefits determination...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Courts Say Abuse of Discretion Standard is "Highly Deferential" to Plan Administrator's Denial of Benefits

In Rittinger v. Healthy Alliance Life Ins. Co., 914 F.3d 952 (5th Cir. Jan. 31, 2019), and Roebuck v. USAble Life, 380 F. Supp. 3d 852 (E.D. Ark. Mar. 30, 2019), the courts found no abuse of discretion where the ERISA plan...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Fifth Circuit Defines Meaning of "Regular Occupation" Under LTD Policy

In Nichols v. Reliance Standard Life Ins. Co., 924 F.3d 80 (5th Cir. 2019), the U.S. Court of Appeals for the Fifth Circuit held that when an LTD policy funding an ERISA plan defines "regular occupation" as the way the...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Ninth Circuit Affirms Dismissal in Fibromyalgia Disability Case

In Demko v. Unum Life Ins. Co. of America, 2019 U.S. App. LEXIS 31102 (9th Cir. Oct. 15, 2019), the Ninth Circuit affirmed Unum Life's determination that a Hollywood executive diagnosed with fibromyalgia was not disabled from...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

California Plaintiff Fails to Satisfy Burden of Proof in Long-Term Disability Case

The U.S. District Court for the Central District of California, applying de novo review due to California’s discretionary clause ban, ruled that an employee of Apple, Inc. was not entitled to long-term disability benefits...more

Proskauer - Employee Benefits & Executive...

ERISA Administrative Appeal Barred As Untimely

The First Circuit held that a plaintiff failed to timely exhaust her administrative remedies under a long-term disability plan because the plan’s 180-day time limit for submitting appeals commenced on the date the plaintiff...more

Spilman Thomas & Battle, PLLC

The Need for Clarity: Standard of Review

In Griffin v. Hartford Life & Acc. Ins. Co., 898 F.3d 371 (4th Cir. 2018), the Fourth Circuit addressed the issue of whether a related company of an entity that enjoyed the abuse of discretion standard also was entitled to...more

Rumberger | Kirk

Court Construes Pre-Existing-Condition Exclusion To Avoid Illusory Disability Coverage

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Rumberger partner Josh Lerner discusses the impact of the Eleventh Circuit's decision in Bradshaw v. Reliance Standard Life Ins. Co., 707 F. App’x 599 (11th Cir. 2017) with regard to pre-existing-condition exlusion. ...more

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