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 […]
In a recent case, despite the application of an arbitrary and capricious standard of review, the 6th U.S. Circuit Court of Appeals concluded that when MetLife terminated Wanda Glenn’s benefits, its actions were not ”the result of a deliberative process or that it was based on substantial evidence.” Glenn v. MetLife, 2006 U.S.App.LEXIS 22432 (Sept […]
The issue in the 5th U.S. Circuit Court of Appeals ruling High v. E-Systems Inc Long Term Disability Income and Death Benefit Plan, 2006 U.S.App.LEXIS 19613, (Aug. 3), was whether MetLife had the authority to offset Veterans Administration disability benefits that the plaintiff had been receiving even before he was hired by E-Systems in 1982 […]
A decision from the U.S. Court of Appeals for the Seventh Circuit reveals how a court misunderstood key definitions in a disability case.
The 6th U.S. Circuit Court of Appeals’ ruling in Moon v. Unum Provident Corp., 2006 U.S. App. LEXIS 22321 (June 29) (published), has tremendous instructive value with respect to awards of attorneys’ fees following a Court of Appeals reversal of benefit denial.
Today’s column discusses Burroughs v. Bellsouth Telecommunications Inc., 2006 U.S. Dist. LEXIS 52815. (June 14). Burroughs is a tour de force expose of how the ERISA law has been interpreted by the courts in a manner that thoroughly betrays Congress’ intent to protect promised benefits. U.S. District Judge William Acker Jr., a frequent critic of […]