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In this week’s notable decision, Kaminski v. UNUM Life Ins. Co. of Am., No. 19-CV-1997-SRN-DTS, 2021 WL 411438 (D. Minn. Feb. 5, 2021) (Judge Susan Richard Nelson), a district court in Minnesota examines whether UNUM can evade the State’s ban on discretionary language in disability policies issued or renewed in the state after January 1, 2016 by the insurer’s practice of amending and replacing its disability policies rather than renewing them. The court’s answer: nice try UNUM, but de novo review applies. 

In the summer of 2008, Peter Kaminski was paralyzed in a diving accident. After surgery and physical therapy, Kaminski was able to regain most of his strength but was plagued by chronic pain. In 2016, Kaminski made a claim for short-term disability (“STD”) benefits with UNUM under his employer’s STD plan. Kaminski’s STD claim was approved, and UNUM paid him STD benefits for the maximum time allowed under the plan. When his STD benefits were exhausted, Kaminski made a claim for long-term disability (“LTD”) benefits in April of 2017. 
Continue Reading Unum Unsuccessfully Attempts to Evade Minnesota’s Ban on Discretionary Clauses

Good morning ERISA Watchers! Changes are afoot here. Michelle Roberts, the founder and editor of ERISA Watch, is passing the torch, which Peter Sessions and I, along with all the contributors here at Kantor & Kantor, will endeavor to carry forward in the enlightening tradition for which this newsletter is known. While most things will remain the same for you, our esteemed readers, we do plan some special issues and other exciting changes in the future, so stay tuned.

For the very first edition under the new editors, it is fitting that this week’s notable decision is a favorable one obtained by your departing editor, Michelle Roberts, and Kantor & Kantor Associate Monica Lienke, in a difficult disability case. Hamid v. Metropolitan Life Ins. Co., No. 20-CV-01601-VC, 2021 WL 405225 (N.D. Cal. Feb. 5, 2021), was heard by the Honorable Vince Chhabria. In ruling for the plaintiff, the court reaffirmed that objective evidence was not required to prove disability. The court also determined that certain evidence in the record contained objective indications of disability that MetLife had ignored. Additionally, the court found that MetLife’s failure to engage with Hamid’s favorable Social Security disability determination in a meaningful way further undermined its finding of no disability.
Continue Reading New Editors and a K&K Victory

This week’s notable decision, Rois-Mendez v. California Physicians’ Service dba Blue Shield of California, Case No. 20-cv-02227, 2021 WL 242906 (C.D. Cal. Jan. 25, 2021), is a proton therapy cancer treatment denial case with a twist. Rois-Mendez was covered under a fully-insured Blue Shield plan when he was diagnosed with parotid gland cancer…