The 2nd U.S. Circuit Court of Appeals recently issued a significant ruling involving disability benefits. In Durakovic v. Building Service 32BJ Pension Fund, 2010 U.S.App.LEXIS 12937 (2nd Cir. June 24, 2010), Bejaze Durakovic, a Yugoslavian emigrant with a grade school education, worked as an office cleaner in New York City until she stopped working in […]
Two recent district court rulings ,Day v. AT&T Disability Income Plan, 2010 U.S.Dist.LEXIS 61477 (N.D.Cal. June 8, 2010) and Riley v. Sun Life and Health Assur.Co., 2010 U.S.Dist.LEXIS 61881 (D.Neb. June 18, 2010), starkly illustrate how the standard of review in ERISA cases can dramatically impact the application of offsets against benefits payable. In both […]
The issue of whether accidental death benefits are payable to the survivors of drunken drivers has been the subject of numerous reported decisions over the past 20 years. Surprisingly, despite insurers’ efforts to exclude coverage under accidental death insurance policies under such circumstances, policies still exist that lack an explicit exclusion for deaths occurring where […]
The Employee Retirement Income Security Act of 1974 (ERISA) provides: “In any action under this title (other than an action described in paragraph 2) by a participant, beneficiary, or fiduciary, the court in its discretion may allow a reasonable attorney’s fee and costs of action to either party.” 29 U.S.C. § 1132(g)(1). In Hardt v. […]
A recent ruling from a federal court in Texas illustrates the difference between an ERISA welfare benefit and a payroll practice. While the former is subject to federal law, disputes arising in relation to payroll practices belong in state court. In Monkhouse v. Stanley Associates, Inc. Short Term Disability Income Plan, 2010 U.S.Dist.LEXIS 40555 (S.D.Tex. […]
Court decisions have grappled with the challenges of the ERISA limitations period.
A recent district court ruling involving a commercial airline pilot discussed a fascinating issue known as “legal” disability. A legal disability, in contrast to a factual disability, occurs on account of a loss of licensure or certification to practice in a profession. The cases discussing legal disabilities involve issues such as loss of a medical […]
A decision from the U.S. District Court for the District of Columbia reviews the deficiencies of a disability determination.
The case of Cox v. CIGNA Group Insurance, 2010 U.S.Dist.LEXIS 17164 (E.D. Ky., Feb. 24), is illustrative of a pattern suggestive of possible systematic maladministration of disability claims, a finding also made by the California Department of Insurance. California conducted a market conduct study of CIGNA’s disability claim handling and found numerous examples of unfair […]
A recent 6th U.S. Circuit Court of Appeals ruling raises the question of who gets the last word in an ERISA claim appeal. In Balmert v. Reliance Standard Life Ins.Co., 2010 U.S.App.LEXIS 2439 (6th Cir. Feb. 5, 2010), the plaintiff, Maribea Balmert, worked as an accountant-tax manager for Big Lots Inc. beginning in 2001. She […]
A recent ruling from the 1st Circuit illustrates a marked disparity between how different federal circuits adjudicate ERISA claims. In Richards v. Hewlett-Packard Corp., 2010 U.S.App.LEXIS 1010 (1st Cir., Jan. 19), the plaintiff, Edward Richards, who worked for Digital Equipment Corporation from 1984 to 1991 as a software engineer, became disabled at age 39 due […]
The saga of Fitts v. Unum Life Ins.Co. of America, 2010 U.S.Dist.LEXIS 2529 (D.D.C. Jan. 13, 2010), which has spanned more than 10 years, has finally come to an end. The case went to the Court of Appeals twice on the issue of whether Unum’s limitation on the duration of benefits for mental and nervous disorders applied to bipolar disorder suffered by Jane Fitts. After the most recent appellate ruling, which I wrote about in an earlier article (“Struggle over ‘mental illness’ exclusions,” Chicago Daily Law Bulletin, March 31, 2008), the parties finally reached a settlement.