Disability Benefits

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Another court questions impartiality of doctor

A federal judge recently looked beyond the claim record and into a reviewer’s wallet in concluding that an insurer improperly terminated disability benefits. Plaintiff Igor Gunn, a financial adviser, sought disability benefits due to symptoms of multiple sclerosis, fainting spells and anxiety. After initially approving the claim, Reliance Standard terminated benefit payments after 24 months, […]

Claimant denied fair chance to continue benefits

A recent 7th U.S. Circuit Court of Appeals case could aptly be entitled ”Halpin Redux,” since the decision was written by Judge Kenneth F. Ripple, who penned Halpin v. W.W. Grainger Inc., 962 F.2d 685 (7th Cir. 1992), and the case covers the identical ground. In Schneider v. Sentry Group Long Term Disability Plan, 2005 […]

Death apparently not enough to prove disability

The disability insurance policy at issue in a federal court decision acknowledged that the insurer was a fiduciary and had discretion to determine eligibility for benefits and construe the policy terms. The policy further stated that ERISA fiduciaries ”have an obligation to administer the plan prudently and to act in the interest of you and […]

Judge questions distinction set for types of illness

Chief U.S. District Judge William Young, the author of the provocative indictment of the claims practices of the Unum Provident Corp. in Radford Trust v. First Unum Life Insurance Company of America, 321 F.Supp.2d 226 (D. Mass. 2004), has written yet another thoughtful opinion. The ruling in Iwata v. Intel Corp., 2004 U.S. Dist. LEXIS […]

Judge takes aim at disability insurers, ERISA

In a stinging decision against an arm of the major worker disability insurer Unum Provident Corp., a federal judge charged that the Employee Retirement Income Security Act falls well short of its goals. The plaintiff, Radford Trust to which a worker’s claim was assigned, brought an ERISA claim on behalf of the trust’s beneficiary, identified […]