The Chartwell Chronicles: Permanent Disability
Physician Employment Agreements: Focus on Financial Planning
An Overview of New Jersey Workers' Compensation
An Overview of Massachusetts Workers' Compensation
Workers' Compensation Academy: Requests by Defense Counsel – A Defense Analysis of Materials Needed from Carriers and Clients for NJ Workers' Compensation Claims
An Overview of New York Workers' Compensation
Workers' Compensation Academy: Pennsylvania COVID-19 Update: Layoff or Furlough from Light Duty as a Result of COVID-19
This month’s Friday Five discusses cases addressing the effect of continuing to receive benefits during the period of alleged disability, reliance on an employer’s records in making a disability determination, the...more
To be insured against a loss or some other event, we pay premiums to an insurance company. If a loss or triggering event actually occurs, we expect our insurance company to compensate us according to our insurance policy....more
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
This month’s Friday Five explores decisions addressing the burden of proving accidental death, policy language and “any occupation” disability, an interpleader case where the insurer was not dismissed from the case, the...more
In 2023, legislatures in five “Southeastern Conference” states passed statutes creating options for employers to voluntarily provide paid family and medical leave (PFML) through insurance benefits purchased from the private...more
This month’s Friday Five explores decisions from around the country discussing differences between LTD and LWOP policies, the breadth of discretion available to claims administrators and the always important topic of timely...more
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
In Steigleman v. Symetra Life Ins. Co., 2023 WL 7413668 (D. Ariz. 2023), a court considered whether a package of various welfare benefit insurance policies an individual business owner arranged for herself and her employees...more
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
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
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
This month’s Friday Five explores recent decisions that range from the effect on disability benefits when medical records are not provided after two appeals, to a case that examines how an award of death benefits is...more
This month’s Friday Five covers cases relating to a plaintiff’s attempts to seal a complaint seeking disability benefits, an administrator’s uncommunicated decision to discontinue its investigation into certain medical...more
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
In Hall v. Aetna Life Ins. Co., 2021 U.S. Dist. LEXIS 117331 (N.D. Cal. June 23, 2021), a California district court held that an ERISA claim administrator properly terminated long-term disability (LTD) benefits after the...more
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
In Ruderman v. Liberty Mut. Grp., Inc., 2021 U.S. Dist. LEXIS 40516 (N.D.N.Y. Mar. 4, 2021), a New York district court held that just because an insurer might have been likely to deny a claim does not excuse a claimant's...more
In Carlile v. Reliance Standard Life Ins. Co., 988 F.3d 1217 (10th Cir. 2021), the Tenth Circuit found the term "active" full-time employee ambiguous and awarded disability benefits to an employee who became disabled after...more
In Gill v. Unum Life Ins. Co. of Am., 2020 U.S. Dist. LEXIS 219416 (N.D. Cal. Nov. 23, 2020), a California federal court held that an ERISA claim administrator properly limited benefits to 24 months under the plan's mental...more
This alert was featured in the March 2021 edition of The LHD/ERISA Advisor In Poisson v. Aetna Life Ins. Co., 2020 U.S. Dist. LEXIS 177216 (C.D. Cal. Sep. 21, 2020), a California district court held that the contractual...more
This month’s Friday Five covers cases relating to disputes between beneficiaries to life insurance policy proceeds, an insurer’s use of independent medical reviewers and in-house nurses to evaluate claims, the preexisting...more
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
This month’s Friday Five discusses cases that explore some fundamental principles of disability benefit litigation. While players and fans return to the favorite fall pastime of football, albeit in the “new normal” under...more
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
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