Giddens v. Equitable Life Assur. Society of the U.S., 2006 U.S.App.LEXIS 8970 (11th Cir. April 12, 2006). The plaintiff, a dentist, purchased two ”own occupation” disability policies from Equitable. Both policies contained provisions for total disability as well as residual (partial) disability. The issue before the court was whether Allen Giddens was totally or partially […]
A decision by the U.S. District Court for the Western District of Wisconsin tackled a thorny issue in ERISA law concerning church plan self-reporting.
Parkman v. Prudential Insur. Co. of America, 2006 U.S.App.LEXIS 5131 (8th Cir., March 1). The plaintiff, who worked at a ”medium” duty job for Armstrong World Industries, sought disability benefits after experiencing thumb and elbow problems, along with acute lumbar spasms.
Johnson, an accounting clerk for Wells Fargo, applied for disability benefits due to rheumatoid arthritis, which caused her significant pain, stiffness and diminished manual dexterity. She originally received intermittent short-term disability leave from 2000 through 2002 before applying for long-term disability due to the rheumatoid arthritis, along with fibromyalgia, which was also diagnosed. MetLife had […]
In a very significant ruling, the 6th U.S. Circuit Court of Appeals extended several recent precedents to reject an insurer’s reviewing doctor’s findings and uphold a judgment reinstating payment of disability benefits. Evans v. Unum Provident Corp., 2006 U.S.App.LEXIS 1359 (Jan. 20, 2006). The plaintiff, a nursing-home administrator, became disabled due to a seizure disorder […]
The plaintiff, a pharmaceutical sales representative, suffered from degenerative spinal disc disease, which progressively worsened to the point where he could no longer maintain employment.
A federal judge in Georgia recently answered the question of whether the penalties that are available under § 502(c)(1) of the Employee Retirement Income Security Act, 29 U.S.C. § 1132(c), up to $110 per day for failure to provide plan participants and beneficiaries with plan documents on request, applies to documents sought as part of an appeal made pursuant to section 503. Montgomery v. Metropolitan Life Insurance Co., 2005 U.S. Dist. LEXIS 34915 (N.D. Ga., Nov. 30).
A federal court in Virginia recently confronted a situation that arises with some degree of regularity: a judgment is entered by a court, the loser files a notice of appeal and then offers to settle the case, but imposes as a condition of the settlement that the judgment be vacated.
A federal judge recently looked beyond the claim record and into a reviewer’s wallet in concluding that an insurer improperly terminated disability benefits.
A recent 7th U.S. Circuit Court of Appeals case could aptly be entitled ”Halpin Redux,” since the decision was written by Judge Kenneth F. Ripple, who penned Halpin v. W.W. Grainger Inc., 962 F.2d 685 (7th Cir. 1992), and the case covers the identical ground.
In Schneider v. Sentry Group Long Term Disability Plan, 2005 U.S. App. LEXIS 19273 (7th Cir., Sept. 7), an employee of Sentry Life began receiving disability benefits in 2001 due to major depression.
In this short but fascinating ruling, a federal court in Florida analyzed defendant Unum Life Insurance Co.’s motion for a protective order after the plaintiff issued notices to depose Unum claims employees and one of the insurer’s doctors. The claimed basis for the protective order was Unum’s contention that the depositions would not lead to […]
The disability insurance policy at issue in a federal court decision acknowledged that the insurer was a fiduciary and had discretion to determine eligibility for benefits and construe the policy terms. The policy further stated that ERISA fiduciaries ”have an obligation to administer the plan prudently and to act in the interest of you and other plan participants and beneficiaries.”