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Updates on the latest in benefits news and practical pointers for your benefits-related issues.

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Payment delays merely encourage denials

After a district court overturned Liberty’s termination of disability payments in Gerhardt v. Liberty Life Assur.Co. of Boston,2009 U.S.App.LEXIS 16170 (8th Cir. July 23), it remanded the claim to Liberty for further proceedings. Instead of proceeding with the remand, Liberty sought to appeal the ruling. However, the 8th U.S. Circuit Court of Appeals concluded the […]

Efficiency, Expediency Need to Give Way to Fairness

A district court in New York recently overturned a disability benefit termination decision by MetLife, citing a number of reasons and highlighting several issues that frequently arise in disability claims. In Solomon v. MetLife, 2009 U.S.Dist.LEXIS 51507 (S.D.N.Y. June 18), Judge Robert W. Sweet from the Southern District of New York, presented a thoughtful analysis worthy of discussion.

Ruling provides thoughtful primer on discovery

The recent Geer v. Hartford Life & Accid.Ins.Co., 2009 U.S.Dist.LEXIS 48332 (E.D.Mich. June 9), is one of the more thoughtful and carefully analyzed discovery rulings issued in the wake of Metro. Life Ins.Co. v. Glenn, 128 S.Ct. 2343 (2008), which dealt with the structural conflict inherent in an insurer’s dual role as claim administrator/payor of […]

Settlement did not justify vacatur: U.S. court

Can a party who loses in federal court condition a settlement on appeal on the district court vacating its ruling? That was the issue presented in Welch v. Unum Life Ins.Co. of America, 2009 U.S.Dist.LEXIS 34018 (D.Kan. April 22, 2009). The plaintiff initially won this case, but the court of appeals reversed and remanded. Welch […]

De Novo Review Is not a Rubber Stamp

The deferential standard of review given to insurance companies in ERISA cases was subject to a rigorous examination in Kramer v. Paul Revere Life Ins. Co., 2009 U.S.App.LEXIS 7387 (6th Cir. April 8, 2009)(unpublished). There, an obstetrician and gynecologist, Dr. Lois Kramer, had two disability insurance policies underwritten by the same insurer.

Ruling shows courts must take more responsibility

A recent ruling from the 6th U.S. Circuit Court of Appeals, DeLisle v. Sun Life Assurance Company of Canada, 2009 U.S.App.LEXIS 4251 (March 4), illustrates how courts are now engaging in a more probing and thorough review of ERISA benefit denials. Sherry DeLisle, who sustained significant injuries in an automobile accident, was fired from her […]

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 […]

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