- Volume 18, Issue #7
- Termination Of Disability Benefits Was Arbitrary, Capricious, Panel Says
DENVER - A district court did not err in reversing a disability insurer's termination of a claimant's long-term disability (LTD) benefits because the insurer failed to address whether the claimant was capable of working on a full-time basis, the 10th Circuit U.S. Court of Appeals said Jan. 2 (Carl Van Steen v. Life Insurance Company of North America, Nos. 16-1405, 16-1421, 10th Cir., 2018 U.S. App. LEXIS 17).
- Disability Insurer Erred In Finding Claimant Could Work In Own Occupation, Judge Says
LOS ANGELES - A California federal judge on Dec. 21 determined that a disability insurer erred in denying a claim for long-term disability benefits under the plan's own-occupation standard because the description of the claimant's position as an assistant news editor in the Department of Labor's Dictionary of Occupational Titles is outdated and does not accurately describe the duties of the claimant's position (Kenneth Popovich v. Metropolitan Life Insurance Co., et al., No. 15-9791, C.D. Calif., 2017 U.S. Dist. LEXIS 210427).
- Termination Of Disability Benefits Was Reasonable Under Any-Occupation Standard
CINCINNATI - A disability insurer's termination of long-term disability (LTD) benefits was not arbitrary and capricious because the insurer's decision to terminate benefits under the plan's any-occupation standard is supported by substantial medical evidence and was based on a deliberate reasoning process, the Sixth Circuit U.S. Court of Appeals said Jan. 2 (Bari Kemper v. Life Insurance Company of North America, et al., No. 16-6507, 6th Cir., 2018 U.S. App. LEXIS 55).
- 4th Circuit Affirms Disability Insurer Did Not Abuse Its Discretion
RICHMOND, Va. - The Fourth Circuit U.S. Court of Appeals on Dec. 19 affirmed a district court's ruling that a disability insurer did not abuse its discretion in terminating a claimant's long-term disability (LTD) benefits (Kimberly H. Stoddard v. First Unum Life Insurance Co., No. 16-2065, 4th Cir., 2017 U.S. App. LEXIS 25581).
- Disability Plan Administrator Did Not Err In Terminating Claimant's Benefits
BIRMINGHAM, Ala. - A disability plan administrator did not act arbitrarily and capriciously in terminating a claimant's short-term disability (STD) benefits because the medical evidence supports the plan administrator's decision, an Alabama federal magistrate judge said Jan. 9, noting that the claimant's benefits were extended for an additional seven months after the claimant's second appeal (D'Anza Johnson v. AT&T Umbrella Benefit Plan No. 3, No. 15-1074, N.D. Ala., 2018 U.S. Dist. LEXIS 3379).
- U.S. Supreme Court Refuses To Review 2nd Circuit's Offset Ruling
WASHINGTON, D.C. - The U.S. Supreme Court on Dec. 11 refused to review the Second Circuit U.S. Court of Appeals' ruling that a New York law barring the offset of a claimant's disability benefits with the proceeds of the claimant's settlement of a personal injury suit is not preempted by the Employee Retirement Income Security Act (Aetna Life Insurance Co. v. Salvatore Arnone, No. 17-416, U.S. Sup.).
- Insurer Entitled To Offset LTD Benefits Based On Social Security Awards
NEW ORLEANS - A disability insurer was entitled to offset a claimant's long-term disability (LTD) benefits based on his Social Security disability award and a separate award to his son for family Social Security disability benefits, a Louisiana federal judge said Dec. 19 in granting the insurer's motion for summary judgment (John Jackson v. Aetna Life Insurance Co., No. 16-15837, E.D. La., 2017 U.S. Dist. LEXIS 208188).
- Federal Judge Denies Disability Claimant's Motion For Contempt
BILLINGS, Mont. - A Montana federal judge on Dec. 19 denied a disability claimant's motion for contempt after determining that the insurer reasonably believed that it was entitled to a stay of a judgment in the disability claimant's favor while it pursued an appeal (Theresa Sand-Smith v. Liberty Life Assurance Company of Boston, No. 17-0004, D. Mont., 2017 U.S. Dist. LEXIS 208486).
- 5th Circuit Says Genuine Dispute Exists As To Cause Of Disability
NEW ORLEANS - After finding that a disability claimant raised a genuine dispute of material fact as to the cause of his disability, the Fifth Circuit U.S. Court of Appeals on Dec. 29 reversed a district court's ruling against the claimant on a breach of contract claim (David M. Cox v. Provident Life and Accident Insurance Company, No. 16-60831, 5th Cir., 2017 U.S. App. LEXIS 27036).
- Federal Judge Dismisses Breach Of Fiduciary Claim In Disability Benefits Suit
RICHMOND, Va. - A Virginia federal judge on Dec. 22 dismissed a breach of fiduciary duty claim against a long-term disability plan and its plan administrator after determining that the breach of fiduciary claim is a reformulation of the claimant's wrongful denial of benefits claim (Faye F. Archer v. SunTrust Bank, et al., No. 17-616, E.D. Va., 2017 U.S. Dist. LEXIS 211290).
- 5th Circuit Says 1-Year Statute Of Limitations Bars Disability Claimant's Suit
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Dec. 14 affirmed a district court's ruling that a disability claimant's suit is barred under Louisiana's applicable one-year statute of limitations because the suit was not filed within a year after the claimant requested plan documents from the plan administrator (Todd M. Babin v. Quality Energy Services Inc., No. 17-30059, 5th Cir., 2017 U.S. App. LEXIS 25275).
- Disability Claimant Not Entitled To Jury Trial; Demand For Jury Dismissed
MEMPHIS, Tenn. - A Tennessee federal judge on Dec. 20 granted a disability insurer's motion to dismiss as it pertained to a claimant's demand for a jury trial because the claimant is not entitled to a jury trial under the Employee Retirement Income Security Act (Patricia Bradshaw v. Principal Financial Group, et al., No. 17-2174, W.D. Tenn., 2017 U.S. Dist. LEXIS 209572).
- Washington Federal Judge Grants Disability Claimant's Motion For Attorney Fees
TACOMA, Wash. - A Washington federal judge on Dec. 21 granted a disability claimant's motion for attorney fees after determining that the claimant was successful on the merits of his claim (Anthony Flaaen v. Principal Life Insurance Co. Inc., No. 15-5899, W.D. Wash., 2017 U.S. Dist. LEXIS 210284).
- Additional Discovery Not Needed In Disability Suit, Maryland Federal Judge Says
BALTIMORE - A Maryland federal judge on Dec. 13 denied a disability claimant's motion to compel the production of documents related to the doctors who reviewed the claimant's case after determining that the administrative record is sufficient to determine whether the insurer operated under a conflict of interest (Karin Reidy v. The Unum Life Insurance Company of America et al., No. 16-2926, D. Md., 2017 U.S. Dist. LEXIS 204705).
- Motion To Remand Denied; Disability Insurer Met Burden Of Proving Fraudulent Joinder
BIRMINGHAM, Ala. - An Alabama federal judge on Dec. 21 denied a disability claimant's motion to remand a suit seeking long-term disability benefits after determining that the disability insurer met its burden of proving that its insurance agents were fraudulently joined to defeat federal diversity jurisdiction (Glen L. Brawley, DMD v. Northwestern Mutual Life Insurance Co. et al., No. 17-1513, N.D. Ala., 2017 U.S. Dist. LEXIS 210031).
- Change For Disability Plans' Claims Procedures To Be Effective April 1
WASHINGTON, D.C. - The U.S. Department of Labor (DOL) on Jan. 5 announced that a final rule amending the claims procedure requirements for employee disability benefit plans governed by the Employee Retirement Income Security Act will go into effect on April 1.