Disability Benefits

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Ruling exposes defects in insurer’s determination

Functional capacity evaluations are frequently used in disability insurance evaluations. While some courts have deemed such testing reliable, Alfano v. Cigna Life Ins.Co. of N.Y., 2009 U.S.Dist.LEXIS 7688 (S.D.N.Y. Jan. 30), offers an object lesson as to why courts need to be careful in assessing such tests. The plaintiff in Alfano worked in an administrative […]

Court Right to Look at Big Picture in Benefits Case

A thoughtful examination of the underpinning of a disability benefit termination resulted in a reversal of the insurer’s decision in Anderson v. Nationwide Mut.Ins.Co., 2009 U.S.Dist.LEXIS 1859 (S.D.Iowa Jan. 12). The claim arose when the plaintiff had to cease working after failed back surgery. Before her claim was approved, Nationwide had Anderson undergo an independent medical examination which supported the benefit claim. The independent physician reported that Anderson was incapable of working at any job because pain prevented her from sustaining a position for a long enough time to accomplish any productive tasks.

Ruling puts Glenn decision to work

McCauley v. First Unum Life Ins. Co., 2008 U.S.App.LEXIS 26094 (2d Cir. Dec. 24), recently issued by the 2d U.S. Circuit Court of Appeals, is the first major appellate ruling to fully appreciate the impact of Metropolitan Life Insurance Co. v. Glenn, 128 S. Ct. 2343 (2008), in evaluating benefit claim denials under ERISA. The […]

Ruling an indictment of Unum’s operations

A federal court in Nevada recently issued findings of fact and conclusions of law denying a motion for a new trial in Merrick v. Paul Revere Life Ins.Co., No. CV-S-00-0731-JCM-RJJ (D.Nev. Nov. 17), where a jury returned a bad faith verdict against Paul Revere Life and its parent corporation, Unum Provident, in the sum of […]

An end to lenient regime of claim reviews

The 4th U.S. Circuit Court of Appeals recently issued an instructive, albeit unpublished ruling, in Gorski v. ITT Long Term Disability Plan, 2008 U.S.App.LEXIS 22904 (4th Cir. Nov. 3, 2008) (unpublished), which points to a new way of evaluating disability benefit denials under the abuse of discretion standard. The plaintiff, who had undergone back surgery […]