The main lesson taught by a recent federal court ruling issued in Florida, Wilson v. Walgreen Income Protection Plan, 2013 U.S.Dist.LEXIS 62021 (M.D.Fla. April 29, 2013), is that the Employee Retirement Income Security Act (ERISA) imposes duties of good faith and fair dealing that preclude deceptive and unreasonable claim handling tactics. The plaintiff, Deborah Wilson, […]
Woody Allen is quoted as saying that 80 percent of life is just showing up. That was the lesson taught by Neaton v. Hartford Life and Acc.Ins.Co., 2013 U.S.App.LEXIS 5814 (6th Cir. March 21, 2013)(non-precedential) which focused on James Neaton’s absences from work while recovering from multiple surgeries. Neaton, who worked as a debt collector, […]
Is a significant risk of relapse, if a disability benefit claimant were to return to work, a current disability? That was the question answered in Colby v. Union Security Ins. Co., 2013 U.S.App.LEXIS 1149 (1st Cir. Jan. 17, 2013). Although the court acknowledged that another court of appeals had decided the issue differently, in this […]
All disability insurance policies contain provisions requiring that insureds receive regular care from a physician. However, such clauses are usually liberally interpreted. For example in Heller v. Equitable Life Ins. Soc’y, 833 F.2d 1253, 1257 (7th Cir. 1987), the court ruled that such a clause could not be read to require an insured to undergo […]
As the recent case of White v. Prudential Ins.Co., 2012 U.S.Dist.LEXIS 160773 (E.D.Pa. Nov. 9, 2012) illustrates, whether a disabling condition is psychiatric or physical is not easily determined. The plaintiff in this case, James White, worked as the chief operating officer, chief financial officer and director of risk management at Holt Oversight & Logistical Technologies. In 2007, White was seriously injured in a rollover car accident that occurred when his vehicle was struck by another car.
A federal court has ruled that an insurance company’s use of surveillance in denying a claim for disability benefits was an abuse of discretion. In Spooner v. Reliance Standard Life Insurance Co., 2021 WL 2720302 (E.D.N.Y. July 1, 2021), the plaintiff was a former account executive with a media company who stopped working due to chronic pain from fibromyalgia, a sleep disorder and a psychiatric condition.