In 1989, the Supreme Court issued Firestone Tire & Rubber Co. v. Bruch, 489 U.S. 101 (1989), which permitted the inclusion of language in employee benefit plans (including insurance policies) that would trigger a deferential standard of court review in ERISA cases.
The plaintiff, a loan originator, originally became disabled in 1993 due to an ankle injury. Although her ankle improved, she was also involved in a serious car accident, and her benefits were continued until 1996 when Hartford cut off the benefit payments even though she continued to suffer from pain, fatigue, problems with memory and […]
Dennis Paese, a long-time employee and director of labor relations for Sequa Corporation, was severely injured in a car accident. Paese v. Hartford Life and Accident Insur. Co., 2006 U.S.App.LEXIS 13007 (2d U.S. Circuit Court of Appeals May 24,2006).
The plaintiff commenced this action seeking injunctive relief under the ERISA statute after Prudential terminated her benefit claim for the third time. Perkins v. Prudential Insur. Co. of America, 417 F.Supp.2d 1149 (C.D.Cal. March 1, 2006). Perkins initially became disabled in 1997; after Prudential denied her claim, litigation resulted in an award of benefits. Another […]
It is fascinating how far Judge Richard A. Posner has come. Posner wrote the opinion in Rud v. Liberty Life Assur.Co.,438 F.3d 772 (7th Cir. 2006). However, in Van Boxel v. The Journal Co. Employees’ Pension Trust, 836 F.2d 1048, 1052 (7th Cir. 1987), he wrote:
Editor’s note: This is the first of two parts. The second will run on Tuesday. Rud v. Liberty Life Assur.Co.,438 F.3d 772 (7th Cir. 2006). After injuring his back in a fall, the plaintiff filed a disability claim under his employer-sponsored group disability insurance plan. Although benefits were paid under an initial 24 month ”own […]
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.