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 […]
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 […]
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 […]
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 […]
This article discusses Patton v. MFS/Sun Life Financial Distributors Inc., 2007 U.S.App.LEXIS 5715, an opinion issued by the 7th U.S. Circuit Court of Appeals on March 12.
The saga of this case, which involved a claim of disability due to complications of diabetes, is a long one that began in 2002 when Unum initially denied the claim for benefits and upheld its decision when the plaintiff submitted her pre-suit appeal. The case, Metzger v. Unum Life Ins.Co. of America, 2007 U.S.App.LEXIS 3755, […]
The plaintiff, Gary Rittenhouse, won this case in the district court; however, he suffered a crushing defeat in the Court of Appeals. Rittenhouse, an officer of UnitedHealth Group, began experiencing progressive hearing loss beginning in the 1980s. In 2002, Rittenhouse’s hearing loss had advanced from moderate to severe, and further deterioration occurred in 2003 at […]
The plaintiff in this case initially became disabled in 1985 as the result of a work accident when a hydraulic door fell on him and fractured his C3 vertebra. Rehabilitation efforts were unsuccessful; and Sloan began receiving long-term disability benefits in the late 1980s. After 24 months, the definition of disability changed from one in […]
The plaintiff in this case was involved in a tragic sledding accident in 1997 that resulted in the death of the plaintiff’s grandson and severe injuries to himself. Fulayter v. Prudential Insur. Co. of America, 2007 U.S.Dist.LEXIS 8394 (D.Ariz. Feb. 6). After a significant period of rehabilitation, Fulayter was able to return to work; however, […]
In a short, but highly instructive ruling, U.S. District Judge Gerard Lynch ordered that CIGNA disclose its disability insurance claim manual without a protective order, overruling an objection that the insurer might suffer ”competitive injury” if such information was disclosed. Levy v. INA Life Insur.Co. of N.Y., 2006 U.S.Dist.LEXIS 83060 (S.D.N.Y. Nov. 14, 2006). Because […]
The plaintiff, a 55-year-old night cleaner, filed for total and permanent disability benefits due to osteoarthritis of her right knee. The case is Demirovic v. Building Service 32B-J Pension Fund, 2006 U.S.App.LEXIS 25891, from the 2d U.S. Circuit Court of Appeals, Oct. 19, 2006. Accompanying her application was a notice of award from the Social […]
In deciding whether an insurer properly terminated the plaintiff’s benefits, the 6th U.S. Circuit Court of Appeals in Osborne v. Hartford Life & Accident Insur. Co., 2006 U.S.App.LEXIS 24640 (Oct. 3), first noted the issue turned on the meaning of the insured’s ”own occupation” as used in the policy. The plaintiff was the chairman and […]