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Wrongly used standard can deny worthy benefits

In Shane v. Albertson’s Inc., 2007 U.S.App.LEXIS 24092 (9th Cir. Oct. 15), Stacey Shane originally qualified for disability benefits under Albertson’s ERISA-governed disability income plan in 2000 on account of a knee injury; and benefits were paid continuously for two years. However, benefits were terminated in 2003 when the Albertson’s Medical Review Committee determined Shane […]

Examining the nature of illness and injury

In Rich v. Principal Life Ins.Co., 2007 Ill.LEXIS 1157 (Ill.S.Ct. Sept. 20), the plaintiff purchased a disability income policy in 1980 that provided benefits in the event of ”total disability,” defined as ”the complete inability of the insured due to Injury or Sickness to perform any and every duty pertaining to an occupation (as defined […]

Credibility Should Have Been the Issue in Review

In Corry v. Liberty Life Assur.Co. of Boston, 2007 U.S.App.LEXIS 20605 (Aug. 28). the 5th U.S. Circuit Court of Appeals overturned a district court finding in favor of a claimant suffering from fibromyalgia, finding no abuse of discretion in the insurer’s determination.

The plaintiff, who had worked as a sales manager for Dell, became disabled in 1995. She applied for disability benefits from Liberty, and her claim was approved. Social Security also granted benefits.

Benefit Plan Took the Necessary Steps

n LaSalle v. Mercantile Bancorporation Inc. Long Term Disability Plan , 2007 U.S.App.LEXIS 19573 (8th Cir. Aug. 17), the plaintiff, who suffered from severe liver disease and had undergone two liver transplants, began receiving benefits in 1998. Benefits were paid on account of LaSalle’s physical limitations until June 2001.

Line between a job and an occupation

In Weiss v. Prudential Ins.Co. of America, 2007 U.S.Dist.LEXIS 56357 (D.N.J. Aug. 2), the plaintiff, who worked for a country vocational board of education as a food services instructor for special education students was injured when he slipped and fell in a freezer at work and herniated a disk in his back. Weiss had disability […]

Unfair ruling against reasoning behind ERISA

Alison Weidner, who worked for FedEx for more than 15 years, experienced a flare-up in her multiple sclerosis and applied for long-term disability payments when she became unable to work. The plaintiff’s treating neurologist certified her disability; and Broadspire, the claim administrator for the FedEx disability benefit plan, acknowledged that Weidner could not perform her […]

Insured’s silence not enough

The interesting issue presented in today’s case is the effectiveness of a policy amendment introducing a discretionary clause. Burkett v. Union Security Ins.Co., 2007 U.S.Dist.LEXIS 41858 (W.D.Wash. June 7). If the amendment was effective, the court would apply the arbitrary and capricious standard of review to a disability benefit dispute. If not, the de novo […]

No reason to deny jury trials for ERISA claims

The plaintiff in today’s case had been in a serious bicycle accident and suffered cognitive impairments as a result. Gammell v. Prudential Ins.Co. of America, 2007 U.S.Dist.LEXIS 36604 (D.Mass. May 17). On account of his injuries, Thomas Gammell received benefits through his employer’s group disability insurer, Prudential, from 1989 through 2002; however, benefits were terminated […]

Insurance adjuster wins bid for disability benefits

Becky Cooper, who worked as an insurance adjuster, injured her back in a work-related accident while on a business trip. Although she continued to work for two years following the accident, Cooper’s condition worsened to the point where she finally required surgery. While recuperating, Cooper received short-term disability benefits for a period of time from […]

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