Pre-Existing Condition Exclusion Does Not Bar LTD Benefits, Judge Determines
NEW ORLEANS - A disability insurer wrongfully denied a claim for long-term disability (LTD) benefits based on the plan's pre-existing condition exclusion because the back injury the claimant sustained while working was not caused by the claimant's pre-existing degenerative back condition, a Louisiana federal judge said Jan. 13 in awarding the claimant past and future LTD benefits (Karl Meche v, Metropolitan Life Insurance Co., No. 18-3995, E.D. La., 2020 U.S. Dist. LEXIS 5200). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 10, 2020 Category: Medical Law Source Type: news
Bad Faith Claim Against Disability Income Insurer To Proceed, Judge Says
SCRANTON, Pa. - A Pennsylvania federal judge on Jan. 13 denied a disability income insurer's motion for partial summary judgment on a bad faith claim because the insured provided sufficient evidence from which a jury could find that the insurer acted in bad faith in denying the claim for disability income benefits (Joseph D. Dileo v. Federated Life Insurance Co., No. 18-628, M.D. Pa., 2020 U.S. Dist. LEXIS 5003). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 10, 2020 Category: Medical Law Source Type: news
De Novo Standard Of Review To Be Applied In Disability Benefits Dispute
MOBILE, Ala. - A de novo standard of review must be applied in a disability benefits dispute because the disability insurer failed to provide the claimant with a full and fair review as required by the Department of Labor regulations governing disability claims, an Alabama federal judge said Jan. 21 in granting a disability claimant's motion for partial summary judgment (Brian McConnell v. American General Life Insurance Co., No. 19-0174, S.D. Ala., 2020 U.S. Dist. LEXIS 9605). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 10, 2020 Category: Medical Law Source Type: news
Disability Insurer's Claims Dismissed; Economic Loss Rule Precludes Claims
WEST PALM BEACH, Fla. - A Florida federal judge on Jan. 27 dismissed a disability insurer's counterclaims for fraud and negligent misrepresentation in a disability and life insurance dispute because the counterclaims are barred by the economic loss rule (ELR), which prohibits tort claims in a contractual dispute (Douglas Kuber v. Berkshire Life Insurance Company of America, No. 19-80211, S.D. Fla., 2020 U.S. Dist. LEXIS 14121). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 10, 2020 Category: Medical Law Source Type: news
Panel Says Fraud Act Claim Alleged By Disability Claimant Cannot Stand
NEW YORK - A trial court erred in denying a disability insurer's motion to dismiss a claim alleging violation of New Jersey's Consumer Fraud Act (NJCFA) because a wrongful denial of benefits claim is not actionable under the NJCFA and the claimant failed to allege any deceitful conduct related to the procurement or issuance of the disability policy, the First Department of the New York Supreme Appellate Division said Jan. 23 (Yochanan Bulka v. Metropolitan Life Insurance Co., No. 657560/17, N.Y. Sup., App. Div., 1st Dept., 2020 N.Y. App. Div. LEXIS 470). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 10, 2020 Category: Medical Law Source Type: news
Disability Claimant's Motion To Remand Denied; Federal Jurisdiction Is Proper
LOUISVILLE, Ky. - A disability claimant's allegations against Kentucky's insurance commissioner and the Kentucky Department of Insurance (DOI) must be dismissed, a Kentucky federal judge said Jan. 9 after determining that the claimant failed to exhaust all administrative remedies with the commissioner and the DOI (Charles A. Knoppe v. Lincoln National Life Insurance Co., et al., No. 18-264, W.D. Ky., 2020 U.S. Dist. LEXIS 3612). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - February 10, 2020 Category: Medical Law Source Type: news
Panel Says Opinions Of Disability Claimant's Treating Physicians Must Be Considered
SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Jan. 7 vacated and remanded a disability claimant's suit seeking long-term disability benefits after determining that a district court erred in failing to consider letters from the claimant's treating physicians who were not provided with the opportunity to rebut the opinion of one of the insurer's examining physicians (Lea Wagenstein v. Cigna Life Insurance Co., et al., No. 18-55955, 9th Cir., 2020 U.S. App. LEXIS 482). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
5th Circuit Affirms Ruling That Disability Insurer Did Not Abuse Its Discretion
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Dec. 6 affirmed a district court's ruling that a disability insurer did not abuse its discretion in finding that a claimant was not disabled from performing the duties of her own occupation as an attorney because the objective medical evidence clearly supports the insurer's finding (Anne Wittmann v. Unum Life Insurance Company of America, No. 19-30254, 5th Cir., 2019 U.S. App. LEXIS 36311). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Termination Of LTD Benefits Was Not Based On Substantial Evidence
BALTIMORE - A federal judge in Maryland on Dec. 4 granted a disability claimant's motion for summary judgment and reinstated the claimant's benefits after determining that the disability insurer's termination of long-term disability (LTD) benefits was not based on substantial evidence (Dana Krysztofiak v. Boston Mutual Life Insurance Co., No. 19-0879, D. Md., 2019 U.S. Dist. LEXIS 209452). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Orthopedic Surgeon Not Entitled To Total Disability Benefits, Judge Determines
NEW YORK - A New York federal judge on Jan. 3 granted a disability insurer's motion for summary judgment and denied a disability claimant's motion for summary judgment after determining that an orthopedic surgeon is not entitled to total disability benefits for the periods in which he returned to work because he was still able to complete the majority of his responsibilities as an orthopedic surgeon even though he was unable to perform surgeries (Richard Sternberg v. Paul Revere Life Insurance Co., No. 17-8523, S.D. N.Y., 2020 U.S. Dist. LEXIS 1718). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Disability Claimant Met Plan Requirements To Qualify For Benefits
ANN ARBOR, Mich. - A disability claimant is entitled to short-term disability and long-term disability benefits because the claimant proved by a preponderance of the evidence that she met all four conditions listed in the disability plan to qualify for benefits, a Michigan federal judge said Dec. 17 (Brenda Counts v. United of Omaha Life Insurance Co., No. 18-12312, E.D. Mich., 2019 U.S. Dist. LEXIS 216274). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Disability Insurers Did Not Breach Contract; Mental Limitation Properly Applied
NEW ORLEANS - A Louisiana federal judge on Dec. 13 dismissed a disability claimant's complaint after determining that the disability insurers did not breach their insurance policies by limiting the claimant's benefits to 24 months under the policies' 24-month limitation provision for mental disorders (Allan Cougle v. Berkshire Life Insurance Company of America, et al., No. 19-9257, E.D. La., 2019 U.S. Dist. LEXIS 215019). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Disability Insurer Incorrectly Calculated First Day Of Disability, Judge Concludes
CHICAGO - An Illinois federal judge on Dec. 10 granted a disability claimant's motion for summary judgment after determining that the disability insurer incorrectly calculated the claimant's first day of disability and the salary on which his long-term disability (LTD) benefits should be based (Harlan Ten Pas v. The Lincoln National Life Insurance Co., No. 18-3694, N.D. Ill., 2019 U.S. Dist. LEXIS 212284). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Disability Claimant Cannot Collect Consequential Damages, Judge Says
MINNEAPOLIS - A Minnesota federal judge on Jan. 3 granted a disability insurer's motion for partial summary judgment after determining that a disability claimant failed to prove that the insurer's termination of disability benefits caused the claimant to sustain consequential damages in the form of lost employer-provided health and life insurance (Matthew J. Christoff v. Paul Revere Life Insurance Co., No. 17-3515, D. Minn., 2020 U.S. Dist. LEXIS 808). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
Bad Faith Claim Cannot Proceed Without Breach Of Contract, Federal Judge Says
LOUISVILLE, Ky. - A Kentucky federal judge on Dec. 31 granted a disability insurer's motion for summary judgment on a claimant's bad faith claim after determining that the bad faith claim cannot proceed without the breach of contract claim, which was dismissed in a prior ruling by the court (James H. Pogue v. Principal Life Insurance Co., No. 14-599, W.D. Ky., 2019 U.S. Dist. LEXIS 222947). (Source: LexisNexis® Mealey's™ Disability Insurance Legal News)
Source: LexisNexis® Mealey's™ Disability Insurance Legal News - January 13, 2020 Category: Medical Law Source Type: news
