Court Finds Employee Was Totally Disabled
The plaintiff, a pharmaceutical sales representative, suffered from degenerative spinal disc disease, which progressively worsened to the point where he could no longer maintain employment.
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.
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 U.S. App. LEXIS 19273 (7th Cir., Sept. 7), an employee of Sentry Life began receiving disability benefits in 2001 due to major depression.
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 other plan participants and beneficiaries.”
1st Circuit Overlooks Crucial ERISA Distinction
In a very significant ruling, the 1st U.S. Circuit Court of Appeals offered its view on the scope of a de novo judicial review of a benefits denial claim governed by the ERISA law: ”The claimant was not entitled to trial or to admit desired new evidence outside the administrative record or to discovery.” Plaintiff […]
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 […]