Blog Archive
The Fifth Disagrees on Disability Administrator’s Bait and Switch Tactic
On December 16, 2009, the Fifth Circuit held that the failure of a disability claim administrator to provide its basis for denial on appeal during the initial adverse determination did not deprive the Plaintiff of a “full and fair review” or result in any significant...
Arbitrary and Capricious Standard is Not a Rubber Stamp of the Administrator’s Decision
The Sixth Circuit, reversing a district court opinion, found that Zurich American Insurance Company abused its discretion in determining that the loss of a claimant’s leg in a motorcycle accident was not “accidental” simply because he was intoxicated, and that...
News in the Ninth: Reflex Sympathetic Dystrophy
Today, December 16, 2009, where total disability was not in question, the Ninth Circuit affirmed a district court opinion that found that MetLife did not abuse its discretion by concluding that Reflex Sympathetic Dystrophy fell into the disability insurance policy’s...
Florida News: No Damages For Failure to Act in Participant’s Best Interest
On December 14, 2009, the Middle District of Florida found that a plan administrator’s "apparent lack of understanding and concern with its obligations under ERISA as plan administrator" along with its failure “to act in the best interest of the participant” did not...
Alabama Judge Stands Up to MetLife
In a very enlightened and forthright opinion, Judge Acker, from the northern district of Alabama, recognized several common insurance company disability claim tactics as unlawful, or in the context of ERISA, arbitrary and capricious. With a more critical eye of...