Although mental health parity claims have been proliferating in federal courts for more than a decade, it wasn’t until last year that a federal appeals court laid out pleading standards for mental health parity cases.[1] Another appellate decision has now joined the chorus. In Ryan S. v. UnitedHealth Group Inc.,[2] the U.S. Court of Appeals […]
Most disability insurance policies distinguish between disabilities that are due to medical conditions and those that result from behavioral health disorders. For the latter category, benefit payments are typically limited to a maximum of 24 months, while payments for disabilities resulting from medical conditions can continue until the claimant reaches Social Security retirement age. […]
The COVID-19 pandemic has wrought a previously unfathomable level of casualties and economic disruption in the United States and worldwide in just a few short weeks. Since mid-March, 16.9 million Americans have filed jobless claims, and one out of every 10 U.S. workers who had employment prior to the pandemic is now jobless. Many people with […]
Protecting LGBTQ rights is of great importance for this country, and the legal issues related to transgender healthcare can be particularly complicated. Many employer-sponsored healthcare plans now explicitly cover transgender-related healthcare. Part of the reason is likely economic. According to the Williams Institute, there are currently just under 1.4 million Americans who identify as transgender, […]
In Cerone v. Reliance Standard Life Ins.Co., 2014 U.S.Dist.LEXIS 46529 (S.D.Cal. March 28, 2014), after the plaintiff’s accidental death claim based on the death of her husband was denied and her appeal exhausted, Debra Cerone filed suit against Reliance Standard Life Insurance Company. The issue decided in this opinion was whether the de novo or abuse of discretion standard of review applied.
The 9th U.S. Circuit Court of Appeals’ ruling in Jordan v. Northrop Grumman Corp. Welfare Benefit Plan, 2004 U.S.App.LEXIS 10626 (June 1), is one of those cases where plaintiff lawyers are able to learn an important lesson even though this particular plaintiff was unsuccessful.
A federal court in Virginia recently confronted a situation that arises with some degree of regularity: a judgment is entered by a court, the loser files a notice of appeal and then offers to settle the case, but imposes as a condition of the settlement that the judgment be vacated.
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 […]
To qualify for Social Security disability benefits, a claimant must prove an inability to engage in “any” meaningful work, a standard considered extremely difficult to meet. However, as a recent case shows, the FedEx disability benefit plan imposes qualification standards that are even harder than Social Security’s. In Oliver v. Aetna Life Insurance Co., 2015 […]
An inadvertent ambiguity in an insurance policy can be costly as Federal Insurance Co. learned in Tyll v. Stanley Black & Decker Life Insurance Program, 2019 WL 3081061 (D. Conn. July 12, 2019). There, the court resolved a motion for summary judgment seeking a determination as to the amount of business travel accident insurance owed […]
Ever since the Supreme Court’s ruling in Varity Corp. v. Howe, 516 U.S. 489 (1996), courts have grappled with whether plaintiffs who file suit under the Employee Retirement Security Act of 1974 (“ERISA”) can plead simultaneous claims for benefits under § 502(a)(1)(B) along with claims for equitable relief under § 502(a)(3), and if so, under […]