This week’s notable decision is another claimant-unfriendly opinion out of the Fourth Circuit neck of the woods – Dawson-Murdock v. National Counseling Group, Inc., et al., No. 3:18-CV-58, 2018 WL 3744020 (E.D. Va. Aug. 7, 2018). 

In this case, Plaintiff Dawson-Murdock deceased husband, Wayne Murdock, worked full-time for Defendant National Counseling Group, Inc. (“NCG”).  As a full-time employee, he was covered by a group life insurance policy funded by Unum Life Insurance Company of America.  On March 21, 2016, Wayne switched to part-time work.  Though it’s not clear from the opinion as to why Wayne reduced his work hours, the fact that he died six months later suggests it was due to a medical condition.  After he started part-time work, Wayne continued to pay premiums for his life insurance coverage.  Continue Reading Court Rules No Remedy Available for Aggrieved Life Insurance Beneficiary

Good morning, ERISA Watchers!  It was quite the week for ERISA decisions and it was difficult to pick just one notable decision, but the winner is Griffin v. Hartford Life & Accident Ins. Co., No. 17-1251, __F.3d__, 2018 WL 3624872 (4th Cir. July 31, 2018).  The Fourth Circuit affirmed the district court’s determination that abuse of discretion, rather than de novo, applies to Hartford’s decision terminating long term disability benefits and its conclusion that Plaintiff failed to show that Hartford Life’s decision was unreasonable. 

On the standard of review, Griffin contended that the relevant plan documents gave Hartford Life full discretion to determine eligibility for benefits.  However, the decision to terminate his benefits was made by Hartford Fire Insurance Company, which is an affiliated corporation in The Hartford group of companies.  This was based on the W-2 tax forms for the Hartford employees who made the termination decision which showed that they were employees of Hartford Fire.  Continue Reading Fourth Circuit Rules for Hartford Life In Long Term Disability Denial

Good morning, ERISA Watchers!  Today’s report is lighter than usual due to the extra mid-week report sent out this past Wednesday.  My radar has not picked up another notable Circuit decision since then but today I want to highlight a district court opinion, Paquin v. The Prudential Insurance Company of America, 2018 WL 3586397 (D. Colo. July 26, 2018), because it involves a claimant prevailing on a long-term disability claim and those are my favorite kinds of cases!

In Paquin, the plaintiff contracted encephalitis from a mosquito infected by the West Nile virus and sustained brain damage and cognitive difficulties that interfered with his job as a Business Development Director.  Prudential paid Paquin both short term disability benefits and long term disability benefits, until he attempted, unsuccessfully, to return to work for a trial period in 2004.  Continue Reading Court Reverses Prudential’s Termination of Long Term Disability Benefits for Claimant Disabled by West Nile Virus Exposure