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LTD Claimants Win Big as Ninth Circuit Trims “Abuse of Discretion” Standard

LTD Claimants Win Big as Ninth Circuit Trims “Abuse of Discretion” Standard January 11, 2019. By Anne Wallace.
San Francisco, CA In one of the earliest decisions of 2019, the Ninth Circuit gave plaintiffs in long term denied disability lawsuits a new way to challenge benefit denial decisions. It may turn out to be significant.
Read [ LTD Claimants Win Big as Ninth Circuit Trims “Abuse of Discretion” Standard ]

Unum Disability Insurance Claimant Wins Reinstatement of LTD Benefits

Unum Disability Insurance Claimant Wins Reinstatement of LTD Benefits January 8, 2019. By Anne Wallace.
Santa Ana, CA On November 20, 2018, the U.S. District Court for the Central District of California handed Pamela Fleming a resounding victory in her Unum disability insurance lawsuit. Unum had been paying her LTD benefits since 2005, after a serious and well-documented neck injury sustained in a car accident. A change in her treating physician and a brief surveillance video led the insurer to re-evaluate her claim and declare that she had recovered. The insurer terminated her benefits. Judge Cormac J. Carney was not impressed and reinstated her benefits due under the policy.
Read [ Unum Disability Insurance Claimant Wins Reinstatement of LTD Benefits ]

Jury Awards $25.6 Million in Bad Faith Insurance Lawsuit

Jury Awards $25.6 Million in Bad Faith Insurance Lawsuit December 17, 2018. By Anne Wallace.
Oklahoma City, OK In November 2018, a jury awarded nearly $25.6 million to the family of a Oranna Cunningham, a woman who was diagnosed with advanced nasopharyngeal cancer. Her insurer, Aetna, refused to cover the cost of the proton beam therapy recommended by her physician, claiming that it was “experimental or investigational.” After her death, her husband brought a bad faith insurance lawsuit.
Read [ Jury Awards $25.6 Million in Bad Faith Insurance Lawsuit ]

Unum: the Gift of Giving and Taking Away

Unum: the Gift of Giving and Taking Away December 6, 2018. By Jane Mundy.
Chicago, IL: Yet another lawsuit was filed in November against First Unum for allegedly denying long-term disability benefits. In the same month, Unum announced to the media that it had donated $300,000 to a high-school girls’ leadership program.
Read [ Unum: the Gift of Giving and Taking Away ]

Fibromyalgia Sufferer Brings LTD Lawsuit against Life Insurance Co. of North America

Fibromyalgia Sufferer Brings LTD Lawsuit against Life Insurance Co. of North America November 16, 2018. By Anne Wallace.
Los Angeles, CA On September 14, 2018 Marisa Finnerty filed a long term denied disability lawsuit against the Life Insurance Company of North America (LINA), alleging that she had been wrongly denied benefits under her employer, Quest Diagnostics’, long term disability and group life insurance plans. Two things stand out about this lawsuit.
Read [ Fibromyalgia Sufferer Brings LTD Lawsuit against Life Insurance Co. of North America ]

Unum’s Denial of Opioid Overdose Deaths

Unum’s Denial of Opioid Overdose Deaths November 15, 2018. By Jane Mundy.
New Orleans, LA: The giant insurance company Unum—also known as First Unum -- typically denies accidental death benefits (as do most other life insurance companies) by excluding in their policy coverage for deaths related to prescription overdose or for medical or surgical treatment of a sickness or disease. But Unum’s denial didn’t sway Judge Martin Feldman this past August.
Read [ Unum’s Denial of Opioid Overdose Deaths ]

Is a Health Plan Liable for the Negligence of an Unqualified Claims Reviewer?

Is a Health Plan Liable for the Negligence of an Unqualified Claims Reviewer? October 23, 2018. By Anne Wallace.
Sherman, TX Johnson v. UnitedHealthcare raises more questions than it answers about how ERISA protects health plan participants who bring bad faith insurance lawsuits over denied medical claims. Stephen Johnson had more than his share of hardship. The law hasn’t helped him. But it’s a complicated story that will affect claimants and health insurers denying medical claims in California and throughout the country. So hang on.
Read [ Is a Health Plan Liable for the Negligence of an Unqualified Claims Reviewer? ]

UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock

UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock October 15, 2018. By Anne Wallace.
Chattanooga, TN On September 25, 2018, the Sixth Circuit Court of Appeals granted UNUM Life Insurance’s motion for summary judgment, thus ending Richard Ravenscraft’s UNUM disability lawsuit on the grounds that he had not exhausted administrative remedies. These are the rocks on which many long term disability lawsuits have been dashed.
Read [ UNUM LTD Claimants Must Beware of Exhaustion of Remedies Roadblock ]

Mother with Post-Partum Depression Denied Disability Benefits by Hartford

Mother with Post-Partum Depression Denied Disability Benefits by Hartford October 10, 2018. By Jane Mundy.
Chicago, IL: Even though Angela tried to return to work after suffering from postpartum depression, her boss advised that she apply for long term disability with Hartford Health Insurance. But Hartford didn’t agree with Angela’s boss.
Read [ Mother with Post-Partum Depression Denied Disability Benefits by Hartford ]

Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman

Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman September 14, 2018. By Anne Wallace.
San Diego, CA Christopher Wheeler was a Coxswain/Diesel mechanic, a contractor doing heavy physical work for the U.S. Navy Fifth Fleet. On March 17, 2015, he was badly injured during a storm at sea off Bahrain. Hospitals and rehab landed him a computer job for which he had no aptitude or training. When that didn’t work out, his employer, Exelis, Inc. terminated his employment and Metropolitan Life Insurance (MetLife) denied his long term disability benefit application. He filed a long term denied disability lawsuit on August 2, 2018 in the Southern District of California. California’s de novo standard for the review of disability claims under ERISA may work to Wheeler’s benefit.
Read [ Wheeler v. Metropolitan Life Insurance Company Seeks LTD Benefits for Injured Seaman ]

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