Most group disability insurance policies limit the duration of benefit payments for mental impairments. An interesting ruling out of Pennsylvania focuses on what constitutes a “mental impairment.” In Berkoben v. Aetna Life Insurance Co., 2014 U.S.Dist.LEXIS 39385 (W.D.Pa., Feb. 21), a magistrate judge’s report and recommendation, the court recommended overturning Aetna’s termination of benefits based […]
In Cerone v. Reliance Standard Life Ins.Co., 2014 U.S.Dist.LEXIS 46529 (S.D.Cal. March 28, 2014), after the plaintiff’s accidental death claim based on the death of her husband was denied and her appeal exhausted, Debra Cerone filed suit against Reliance Standard Life Insurance Company. The issue decided in this opinion was whether the de novo or abuse of discretion standard of review applied.
Fee awards made pursuant to the Employee Retirement Income Security Act’s (ERISA) fee-shifting statutory provision (29 U.S.C. Section 1132(g)) are a critical part of ERISA litigation. A ruling last month from the 2nd U.S. Circuit Court of Appeals, Donachie v. Liberty Life Assurance Co. of Boston, 2014 U.S.App.LEXIS 4593 (2nd Cir. March 11, 2014), clarified […]
In Fontaine v. Metropolitan Life Ins.Co., 2014 U.S.Dist.LEXIS 41253 (N.D.Ill. March 27, 2014), DeBofsky, Sherman & Casciari scored a major victory in securing an award of long-term disability insurance for a partner in a major law firm. The plaintiff, Mary Fontaine, enjoyed a successful career as a partner practicing in the field of structured finance for the law firm of Mayer Brown in Chicago where she worked for thirty years.
The plaintiff, Nerses Meguerditchian, was initially employed by FedEx in 1991 as a technician who repaired vehicles and ground equipment operated by the company. In 2011, the plaintiff injured his back while working on a vehicle, but participated in FedEx’s temporary return to work program following his injury until April 2011 when he ceased working […]
Whether being able to work part-time affects a claimant’s eligibility for disability benefits depends on several factors.
The relevance of a Social Security disability determination to the outcome of a long-term disability claim has become a hot topic with the courts and insurance regulators. CIGNA and its subsidiary, the Life Insurance Company of North America have been the subject of numerous court rulings as well as a recent regulatory settlement with state […]
Long-term disability insurance cases involving fibromyalgia present special difficulties because there are no objective tests for the condition other than a clinical “trigger-point” test. A recent ruling from California handled by attorney Michael McKuin and decided by Judge Dolly Gee presents an interesting and thorough discussion of such a claim that stands out in noting […]
Statutes of limitation can be very confusing in Employee Retirement Income Security Act cases. Since the provision of ERISA that authorizes claimants to sue to recover benefits (29 U.S.C. Section 1132(a)(1)(B)) lacks its own statute of limitations, courts borrow the most analogous limitations period under state law. But if the benefit plan contains its own […]
Congress authorized claimants seeking employee benefits due under ERISA to bring a ‘civil action’ to recover benefits due or obtain appropriate equitable relief. 29 U.S.C. § 1132(a). The Federal Rules of Civil Procedure contemplate only one form of civil action; and civil actions are to be adjudicated utilizing the procedures specified by the civil procedure […]
A recently filed lawsuit focuses on one of the pitfalls in long-term care insurance, a critical area of practice for DeBofsky, Sherman & Casciari. The lawsuit, filed in federal court in Connecticut, and titled, “Gardner v. CNA Financial,” , alleges that Chicago-based CNA, a major long-term care insurer, wrongfully denied coverage for services provided in […]
The Employee Retirement Income Security Act law creates a number of perverse incentives for insurers that administer benefit claims. Without the availability of remedies beyond the restoration of benefits due, insurers can earn significant profits on delayed payments. A recent 6th U.S. Circuit Court of Appeals ruling, Rochow v. Life Ins. Co. of North America, […]