Author: Mark Debofsky

Court finds conflict in insurer, reviewer relationship

In Caplan v. CNA Financial Corp., 2008 U.S.Dist.LEXIS 28290 (N.D.Cal. April 4), David Caplan, who worked for CNA Financial supervising workers’ compensation claims, suffered a neck injury, which caused severe pain, and spasms that significantly interfered with his ability to work at a computer, his primary job function. Initially, Caplan tried to deal with his […]

Rulings uphold state power over review clauses

Two significant rulings issued days apart upheld the authority of state departments of insurance to prohibit life and disability insurers from including discretionary clauses in their policies that would have the effect of triggering an arbitrary and capricious standard of review under the ERISA law. At issue was the adoption by several states of a […]

A painful burden for disability claimants

Welch v. Unum Life Ins. Co. of America, 2007 U.S.Dist.LEXIS 91796 (D.Kansas Dec. 13, 2007), was before the court on remand from the 10th U.S. Circuit Court of Appeals (Welch v. Unum Life Insur. Co. of America , 382 F.3d 1078 (10th Cir. 2004), where the appellate court ruled that consideration had to be given […]