Diminished Work Ability Does Not Have to Be Total for Total Disability Finding

by Mark Debofsky | Mar 20, 2018 | Disability Benefits, Residual/Partial vs. Total Disability

The outcome of Simmons v. Paul Revere Life Insurance Co., 2018 WL 558960 (W.D. Wash., Jan. 25, 2018), discussed in Part 1 of this column on Monday is not as clear-cut as the court found. Since Dr. William Simmons, a dentist, was no longer able to perform a number of material job duties that were a major part of his practice prior to his car accident, his claim raised serious issues about the protection his disability policy provided.

Is Death Resulting From Autoerotic Asphyxiation “Accidental”?

by Mark Debofsky | Mar 12, 2018 | Accidental Death

Anecdotally, the most litigated accidental death insurance claims involve drunk driving. The next most prevalent type of litigated accidental death claim are cases involving autoerotic asphyxiation. The recent ruling in Tran v. Minnesota Life Ins. Co., 2018 WL 1156326 (N.D. Ill. March 5, 2018) was one such case. The plaintiff was the widow of an […]

The 5th Circuit Finally Gets De Novo Review Right (Somewhat)

by Mark Debofsky | Mar 4, 2018 | ERISA Standard of Review, Health Benefits

In Ariana M v. Humana Health Plan of Texas, Inc., 2018 WL 1096980 (5th Cir. March 1, 2018), a divided Fifth Circuit issued an en banc ruling that finally overturned Pierre v. Conn. Gen. Life Ins. Co., 932 F.2d 1552 (5th Cir. 1991) and concurred with every other Circuit that Firestone Tire & Rubber Co. v. […]

Insurer Loses Out on Effort to Capture Chunk of Med-Mal Settlement

by Mark Debofsky | Feb 7, 2018 | ERISA, Long Term Disability

A Montana federal court began a recent ruling by asking: “Who is the beneficiary of a lawsuit stemming from an ERISA employee’s misfortune? Is it the ERISA plan or is it the unfortunate employee?” The case, Rustad-Link v. Providence Health and Services and Unum Group Corp., 2018 WL 627560 (D. Mont., Jan. 30, 2018), involved […]

Beware of Social Media When Applying for Disability Insurance Benefits

by Mark Debofsky | Feb 7, 2018 | Disability Benefits

A recent article published by Bloomberg Law offers a stark warning to disability insurance claimants who use social media. The article by Jacklyn Wille entitled “Facebook Has a New Friend: Disability Insurers” (https://www.bna.com/facebook-new-friend-n73014475033/) discusses insurers’ use of social media to investigate disability insurance claimants.

Author: Mark Debofsky

Diminished Work Ability Does Not Have to Be Total for Total Disability Finding

Is Death Resulting From Autoerotic Asphyxiation “Accidental”?

The 5th Circuit Finally Gets De Novo Review Right (Somewhat)

Insurer Loses Out on Effort to Capture Chunk of Med-Mal Settlement

Beware of Social Media When Applying for Disability Insurance Benefits

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