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Ruling undercuts ERISA promise of protection

For the last year, there has been an ongoing debate in the federal court in Philadelphia as to whether the Employee Retirement Income Security Act, 29 U.S.C. sec1001, et seq., preempts claims involving insured benefits such as disability or health insurance disputes brought under Pennsylvania’s bad-faith statute, 42 Pa.C.S. sec8371. On the one side are […]

Disability claims will falter without specifics

The 9th U.S. Circuit Court of Appeals’ ruling in Jordan v. Northrop Grumman Corp. Welfare Benefit Plan, 2004 U.S.App.LEXIS 10626 (June 1), is one of those cases where plaintiff lawyers are able to learn an important lesson even though this particular plaintiff was unsuccessful. Vicki Jordan, an administrative secretary for Northrop Grumman, alleged disability due […]

Preexisting conditions: symptoms vs. diagnosis

The 3d U.S. Circuit Court of Appeals recently confronted the question of whether a “preexisting” condition really was preexisting and thus precluded insurance coverage. McLeod v. Hartford Life and Accident Insurance Co., 2004 U.S.App.LEXIS 12253 (3d Cir., June 22). Plaintiff Shirley McLeod, who had been receiving treatment for a variety of illnesses beginning in 1997, […]

Defining ‘disability’ means looking at duties

One of the difficulties in analyzing insurance claims involving disability has to do with deciding whether the individual claiming benefits is unable to perform the duties of his own occupation. The case of Freling v. Reliance Standard Life Insurance Co., 2004 U.S.Dist. LEXIS 7107 (S.D. Fla. 2004) is a very interesting example. An obstetrician/gynecologist, Dr. […]

Courts seek clarity on subjective diseases

Claims involving sicknesses such as fibromyalgia, a condition for which medical science has yet to develop a laboratory test, can be challenging both for claimants and insurers. A recent decision from Minnesota, which followed a ruling from our 7th U.S. Circuit Court of Appeals, is very instructive, though, on the adjudication of such claims. In […]

Ruling warns against failure to communicate

The 8th U.S. Circuit Court of Appeals recently decided a disability benefits case involving a medical condition that is drawing increased attention among neurologists. Abram v. Cargill Inc., 2005 U.S. App. LEXIS 1142 (8th Cir., Jan. 24). Plaintiff Ellen Abram applied for disability benefits in 2000 when she could no longer work due to post-polio […]

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