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 […]
The 1st U.S. Circuit Court of Appeals has issued a major ruling on how courts are to assess employee benefit claim decisions made within the context of ERISA. In Denmark v. Liberty Life Assur.Co. of Boston, 2009 U.S.App.LEXIS 9825 (May 6), the court revisited an earlier ruling in a disability benefits claim involving fibromyalgia (Denmark […]
The impact of a recent Supreme Court ruling involving disability benefits was at issue in Chronister v. Unum Life Ins.Co. of America, 2009 U.S.App.LEXIS 9033 (8th Cir. April 30). This ruling marked the second time the 8th U.S. Circuit Court of Appeals had occasion to consider Sandra Chronister’s application for disability benefits. In the first […]
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 […]
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 Co., 2009 U.S.App.LEXIS 7387 (6th Cir. April 8, 2009)(unpublished).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.
The future of discretionary clauses in ERISA cases is uncertain, as they have come under heavy fire in recent years.
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 […]
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 […]
A recent 2d U.S. Circuit Court of Appeals ruling, Slupinski v. First Unum Life Insur. Co., 2009 U.S.App.LEXIS 1157 (Jan. 23), offers a textbook lesson on attorney’s fee awards as well as the propriety of prejudgment interest awards under ERISA.
A thoughtful examination of the underpinning of a disability benefit termination resulted in a reversal of the insurer’s decision in Anderson v. Nationwide Mut.Ins.Co., 2009 U.S.Dist.LEXIS 1859 (S.D.Iowa Jan. 12). The claim arose when the plaintiff had to cease working after failed back surgery. Before her claim was approved, Nationwide had Anderson undergo an independent medical examination which supported the benefit claim. The independent physician reported that Anderson was incapable of working at any job because pain prevented her from sustaining a position for a long enough time to accomplish any productive tasks.
The recent ruling in McDowell v. Standard Ins.Co., 2008 U.S.Dist.LEXIS 99239 (N.D.Ga. Nov. 24, 2008), focuses on the proper scope of review in an ERISA case adjudicated under the de novo standard. The plaintiff in McDowell was an attorney who suffered back and closed head injuries when he was rear ended by another car traveling […]
McCauley v. First Unum Life Ins. Co., 2008 U.S.App.LEXIS 26094 (2d Cir. Dec. 24), recently issued by the 2d U.S. Circuit Court of Appeals, is the first major appellate ruling to fully appreciate the impact of Metropolitan Life Insurance Co. v. Glenn, 128 S. Ct. 2343 (2008), in evaluating benefit claim denials under ERISA. The […]