Happy Mother’s Day!  This is the one day a year where I can say “But it’s Mother’s Day!” to get my kids to comply without (much) protest.  They also did give me a few hours of peace and quiet today so I could wrap up today’s notable decision.  This week I want to highlight a district court decision, Khan v. Provident Life & Accident Ins. Co., 2019 WL 1970516 (W.D.N.Y. May 3, 2019), that contains a treasure trove of findings for those of us who represent claimants in long-term disability claims.  

The court’s decision comes from its review of the Magistrate Judge’s Report and Recommendation (R&R) denying the parties’ cross-motions for judgment and recommending a plenary bench trial before the district court.  The court rejected and accepted in part the R&R and granted Plaintiff’s Motion for Summary Judgment.  On de novo review of Provident’s decision, the court found that Plaintiff Khan, who became disabled from his career as a hospital neurologist at the age of 49 due to relapsing polychondritis and polyarthralgias, was entitled to Own Occupation and Any Occupation benefits, denying Provident the opportunity on a remand to consider the Any Occupation claim in the first instance.  
Continue Reading Court Denies Insurance Company Chance to Decide “Any Occupation” Disability Claim for Disabled Neurologist; Orders Payment of Benefits

Good morning, ERISA Watchers!  There were several appellate court decisions this past week, but I want to highlight a district court case that presents a good lesson for employers and plan participants alike when it comes to changes to plan benefits.  In Boyles, Jr. v. American Heritage Life Insurance Company, et al., No. 3:15-CV-274, 2019 WL 1767565 (W.D. Pa. Apr. 22, 2019), Plaintiff Boyles brought suit for the denial of disability benefits against his former employer, St. Marys Insurance Agency; the president of his former employer, Jeffrey Azzato; the employer’s former long-term disability insurer, Allstate; and the employer’s current LTD insurer, Unum.  He also alleged that Azzato and St. Marys breached their fiduciary duties to him.
Continue Reading Court Holds Employer Has No Affirmative Duty to Inform Participant of Change in Disability Insurers

Happy Saturday, ERISA Watchers!  This was another busy week for ERISA decisions that I decided to get this out ahead of schedule again.  It’ll be back on the Monday schedule starting on April 15, everyone’s favorite day.  It was hard to choose just one notable decision since there were several appellate decisions this past week.  I decided to go with my favorite one involving a win for the disability claimant.  This week’s notable decision is Hodges v. Life Ins. Co. of N. Am., No. 18-1279, __F.3d__, 2019 WL 1446800 (10th Cir. Apr. 2, 2019), a matter involving the proper calculation of long-term disability benefits based on the classification of the plaintiff’s job.
Continue Reading Tenth Circuit Holds that Cryotherapy Technician Is a “Sales” Employee under Group Long-Term Disability Policy