Published by The Pellegrin Firm December 3, 2019
Posting on social media can be dangerous if you have filed or are thinking about filing a long-term disability claim. It is now standard operating procedure among long-term disability insurers to check a claimant’s social media history in the hopes of finding anything that may contradict a claimant’s allegations of disability.
Published by the Pellegrin Firm September 28, 2019
Two recent decisions went claimants’ way in preexisting condition denial cancer cases.
Published by The Pellegrin Firm August 13, 2019
This question is one of the “labyrinthine complexities” of ERISA law and practice, as stated by the New Orleans-based U.S. Court of Appeals for the Fifth Circuit in last year’s decision, Manuel v. Turner Indus. Grp., L.L.C., 905 F.3d 859 (5th Cir. 2018).
Published by The Pellegrin Firm August 11, 2019
Living while receiving long-term disability benefits from an insurance company can feel stifling. If the insurance company is paying tens of thousands of dollars to a claimant yearly, it may find it cost effective to invest in surveillance – either through social media or in person – to find a reason to terminate benefits.
In the recent case of Faciane v. Sun Life Assurance Co. of Canada, No. 18-30918, __F.3d__, 2019 WL 3334654 (5th Cir. July 25, 2019), the New Orleans-based U.S. Court of Appeals for the Fifth Circuit followed other federal courts of appeal and several district courts within the Fifth Circuit in finding that the time limit for challenging an ERISA LTD administrator’s benefit calculations in court begins upon notice of the benefit calculation.
Published by The Pellegrin Firm July 29, 2019
The relationship between Long-Term Disability benefits and Social Security Disability benefits creates a lot of confusion and concern among claimants. This relationship is the source of a great number of questions and frustrations.
It seems unfair that an insurance company can underpay a claim and then hide behind time limit defenses when challenged in court. After all, it would seem that the company causes harm to the long-term disability claimant each time it underpays a monthly benefit amount. However, some courts have held that the claimant must challenge the benefit calculation within a …
In a brief per curiam decision dated June 11, 2019, and not designated for publication, a panel of the U.S. Court of Appeals for the Fifth Circuit affirmed a decision of the U.S. District Court for the Southern District of Mississippi rejecting United of Omaha Life Insurance Company’s application of a pre-existing condition exclusion to the claim for long-term disability …
In a recent case, Civil Action No. 19-1939, a ruling by Judge Feldman of the United States District Court for the Eastern District of Louisiana in New Orleans showed the importance of filing for long-term disability while appealing a short-term disability denial. In this case, the plaintiff filed for short-term disability with the defendant, was denied, and filed suit; however, …
Pursuant to Section 104(b) of ERISA and 29 C.F.R. §2560.503-1(h)(2)(iii), a long-term and/or short-term disability insurance company whose policy is governed by ERISA must provide the complete administrative claim file free of charge upon written request. This is important because it gives insight into the reasons the insurance company used to deny the claim and/or terminate disability payments. When a …