Court Right to Look at Big Picture in Benefits Case

by Mark Debofsky | Feb 2, 2009 | Disability Benefits, Pain and Disability

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

by Mark Debofsky | Dec 29, 2008 | Disability Benefits, ERISA

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

by Mark Debofsky | Dec 1, 2008 | Disability Benefits

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

by Mark Debofsky | Nov 24, 2008 | Disability Benefits, ERISA Standard of Review

The 4th U.S. Circuit Court of Appeals recently issued an instructive, albeit unpublished ruling, in Gorski v. ITT Long Term Disability Plan, 2008 U.S.App.LEXIS 22904 (4th Cir. Nov. 3, 2008) (unpublished), which points to a new way of evaluating disability benefit denials under the abuse of discretion standard.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

Court finds conflict in review of claim

by Mark Debofsky | Nov 3, 2008 | Disability Benefits, ERISA Standard of Review

In Wright v. Raytheon Co. Short Term Disability Plan, 2008 U.S.Dist.LEXIS 81951 (Sept. 17), a district court in Arizona thoughtfully applied Metropolitan Life v. Glenn, 128 S.Ct. 2343 (2008), to find that MetLife acted under a conflict of interest when it denied Alan Wright’s disability claim. The plaintiff, who had undergone heart bypass surgery, suffered […]

Insurer’s own guidelines dismissed as not binding

by Mark Debofsky | Oct 6, 2008 | Disability Benefits, Vocational Issues

The case of Pannebecker v. Liberty Life Assurance Company of Boston, 2008 U.S.App.LEXIS 19753 (9th Cir., Sept. 18), involved the question of whether, in assessing a claimant’s ability to work at ”any occupation,” the individual’s pre-disability earnings and station in life have to be taken into consideration. This claim arose in 1996 when Nancy J. […]

Disability Benefits