From the Insurance Companies perspective, the answer is simple- there is no reason for them to pay. My clients are universally surprised to learn that under ERISA the only thing you can sue for are the unpaid LTD benefits. There is no claim for emotional distress, or pain and suffering.…
Most Long Term Disability cases in our office are governed by ERISA as they are non-governmental employer provided benefits. The fact that they are ERISA claims is usually all bad for our clients as the law in this area has a number of inherent anti-claimant aspects. Primary among those aspects…
The federal 8th Circuit Court of Appeals rejected a Long Term Disability Insurer’s (Unum Life Insurance Company) claim denial in the case of Chronister v Unum Life. Citing an important change in the law since Metlife v Glenn the Court determined that Unum’s failure to comply with its own claims…
Recently, the new majority of 4 Michigan Supreme Court Justices upheld a decision by the Court of Appeals in Thorn v Mercy Memorial Hospital. In Thorn, a mother of young children died as a result of a medical error. When the family sued the defendant’s argued that the children could…
In testimony presented to Congress, the Washington Post recently reported on the testimony of Cigna Insurance’s former VP, Wendell Potter who said insurers “make paperwork confusing because ‘they realize that people will just simply give up and not pursue it’ if they think they have been shortchanged.” Referring to the…
In my continuing effort to do the best job that I can for my Long Term Disability Insurance clients I attended that ACI Long Term Disability Insurance Conference in Boston this past week. For the the second year in a row that I have attended this conference I thought it…
Michigan residents injured in auto accidents beware of Auto Insurance tactics. According to the sworn testimony of a representative of State Farm Insurance it appears that the company paid millions of dollars to a consulting firm to analyze and modify its claims handling practices in the mid 90s. According to…
In a tremendously important decision, the 6th Ciruit court of appeals affirmed today a decision limiting the language that disability insurance carriers can include in their policies to protect themselves from making payments. In American Council Of Life Insurers v. Ross, No. 08-1406 , the panel agreed that the Michigan…
In a recent decision, Delisle v Sun Life, the 6th Circuit Court of Appeals affirmed a decision requiring Long Term Disability Insurer Sun-Life to pay disability benefits even though 6 of its hired physicians supported its decision to terminate benefits. In finding that Sun-Life’s decision was arbitrary and capricious the…
The Second Circuit Court of Appeals cited First Unum’s deception as one of the grounds for granting an attorney’s claim for long term disability insurance benefits. In McCauley v First Unum the Court the Court cited several isntances of biased and deceptive claims review in granting McCauley’s claim for disability…