Virginia, DC, and Maryland Personal Injury Attorney News

Disability Insurance Claims

• Unum Orders Functional Capacity Exam, Then Ignores It
  Nov 17, 2009

  A federal court has ruled that it was an abuse of discretion for Unum insurance company to first, order, then ignore a functional capacity exam when determining whether a claimant was entitled to benefits.
  
  You can read more about Unum's loss here.
  
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• Sun Life Could Not Simply Ignore Social Security Award
  Nov 17, 2009

  Sun life lost a case involving rheumatoid arthritis. The court pointed to a favorable social security disability determination and found that since the insurer had encouraged the plaintiff's application it could not simply ignore the award of benefits. The court also was critical of the insurance company's reliance on a file review rather than an examination.
  
  You can read more about this case against Sun Life here.
  
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• Prudential insurance company loses another disability case
  Oct 22, 2009

  In this case out of the federal court in Connecticut Prudential had denied a claim based on fibromyalgia. Prudential had relied on Dr. Paul Howard and his analysis that included a statement that "the pain of fibromyalgia is never sufficient to result in a qualifying disability." That particular position has been rebutted time and time again.
  
  The court said that Prudential's sole reliance upon Dr. Howard's report which articulated a test for disability under which debilitating fibromyalgia induced pain alone could never qualify constituted an arbitrary and capricious eligibility determination. In short the court rejected Prudential's claim that no matter how severe the pain from fibromyalgia is the cannot be disabling.
  
  This case is Lanoue v. Prudential insurance Co. of America and it was decided on September 25, 2009. - 63 - 70

• MetLife Hammered in Disability Case After Ignoring Treating Physician Opinion
  Oct 18, 2009

  A Pennsylvania federal judge hammered Met life for its disability insurance determination.  The Court held that where the insured's treating physicians' disability opinion is unequivocal and based on a long-term physician-patient relationship, reliance on a non-examining physician's opinion premised on a records review alone is suspect and suggest that the insurer is looking for a reason to deny benefits.
  
  Here is the court was highly critical of Met life and its doctor for failing to give a rationale for its conclusion that the claimant was able to work at a sedentary job and the court pointed out that MetLife's doctor ignored a functional capacity evaluation that supported the claim.  The court also was critical of the fact that the reviewing doctors disregarded the plaintiff's job requirements, and only knew that the job was "sedentary."
  
  This case was Kauffman versus MetLife and it was decided on September 24, 2009. - 64 - 70

• Judge Calls Hartford's Review of File "Incomplete, Selective and Unreasonable"
  Sep 30, 2009

  Here's a recent opinion in an ERISA long term disability claim involving Hartford.
  
  The Hartford ERISA disability opinion is long but is well worth reading.
  
  A respected federal judge called Hartford's assessment of the claim "selective" - 65 - 70

• Florida Disability Attorney Nancy Cavey Says Unum's Reversal Rate Almost 50%
  Oct 25, 2008

  This really is incredible. According to Florida attorney Nancy Cavey, Unum's revesal rate is 41%. Apparently after settling with multiple states who claimed Unum was not upholding its end of the bargain, Unum went back to "re-look" at files and changed its decision from "no, you cant have benefits" to "yes, we're sorry, we were wrong" in a shocking 41.7% of the time. Read Nancy Cavey's post on this amazing statistic about Unum here.
  
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• Unum Tries to Rewrite Policy After Claim Was Made
  Sep 24, 2008

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• How Does a "Transferrable Skills" Analysis Work?
  Sep 24, 2008

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• Claimant Wins CIGNA Cardiac Disability Case
  Sep 24, 2008

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• MetLife Admits to Video Surveillance at Claimant's Son's Little League Game
  Sep 19, 2008

  In this disability case involving a claim against MetLife, even video taken at a Little League Baseball Game wasn't enought to terminate benefits.
  
  Virginia Insurance Disability Attorney Ben Glass - 70 - 70

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