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
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 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
In Newsom v. Reliance Standard Life Insurance Company, 2022 U.S. App. LEXIS 4505 (5th Cir. Feb. 18, 2022), the United States Court of Appeals for the Fifth Circuit clarified the difference between an eligibility determination...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 Calkin v. United States Life Ins. Co., 2021 U.S. Dist. LEXIS 82110 (S.D. TX., April 29, 2021), a Texas district court affirmed the insurer’s denial of LTD benefits, holding that while a claimant established diagnoses, he...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
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
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
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
Video surveillance can be an extremely effective tool in making disability benefits determinations. Historically, courts have cautioned that the weight given to surveillance in these cases depends both on the amount and...more
The Seventh Circuit rejected a disability plan participant’s argument that an untimely decision denying his claim for long-term disability benefits warranted changing the standard of review from arbitrary and capricious to de...more
Even when a claims administrator approves a claim for disability benefits, its job is not done. That principle was again demonstrated in the recent case Owings v. United of Omaha Life Insurance Co., No. 16-3128 (10th Cir....more
Seyfarth Synopsis: In a strong decision for insurers, the Eighth Circuit affirmed summary judgment for the administrator, rejected plaintiff’s conflict of interest argument, and found that it was not arbitrary for the...more