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Fort Lauderdale Florida Insurance Law Blog

Federal Circuit Court of Appeals Holds that a Return of Life Insurance Premiums Paid After the Death of an Insured is Insufficient When an Insured Continued to Pay Premiums with the Understanding there was Continued Life Insurance Coverage

In the recent case of McCravy v. Metropolitan Life Insurance Company, 690 F.3d 176 (4th Cir. 2012), the Fourth Circuit Court of Appeals determined that a return of life insurance premiums to Mrs. McCravy after her daughter's death was insufficient where Mrs. McCravy continued to pay premiums through the date of her daughter's death with the understanding that there was continued life insurance coverage for her daughter. The Court ruled that under these circumstances, Mrs. McCravy was entitled to pursue her claims for the full life insurance benefit promised to her under the life insurance policies that she paid continued premiums for until her daughter's death.

Liberty Life's Wrongful Denial of Disability Benefits for Bipolar Disorder and Carpal Tunnel Syndrome

In the case, Suson v. The PNC Financial Services Group, INC., No. 15-CV-10817, 2017 WL 3234809, at *1 (N.D. Ill. July 31, 2017), Liberty Life Assurance Company of Boston, acting as the Plan administrator for PNC's ERISA disability plan, denied long term disability benefits to Ms. Suson who was diagnosed with bipolar disorder in 1996 and had received regular psychiatric treatment since 1990. She had also been treated for bipolar disorder and diagnosed with fibromyalgia and several other degenerative joint diseases for which she received regular treatment. Ms. Suson filed her claim for long term disability benefits on July 24, 2014. She initially based her claim for benefits on bipolar disorder but on September 3, 204 advised Liberty Life that she was also disabled due to fibromyalgia and physical limitations. Liberty denied Suson's claim for LTD benefits on October 8, 2014 stating that the records did not "reasonably support" that she had any "impairments attributable to the presence of mental illness that would preclude" her from working. Ms. Suson appealed the adverse determination and Liberty upheld its denial.

Cigna Continues to Engage in Unreasonable Delay and Denial Tactics of Disability Insurance Claims, Including Alleging that Disabling Conditions are Pre-Existing, After Cigna was Forced to Overturn Denials Under Similar Circumstances

In 2003, Susan Kristoff was diagnosed with breast cancer. After undergoing treatment, it was determined that she was in full remission and cancer free. As a precautionary measure, she was placed on Tamoxifen to prevent the recurrence of cancer in the future. Later, Susan was hired as an outside salesperson for a large corporation and obtained a disability insurance policy with Cigna through her employment. Susan continued to undergo regular evaluations and each time, her physicians assured her she remained cancer free.

Court of Appeals Rules Against Reliance Standard Life Insurance Company and Upholds an Award of Disability Insurance Benefits Under ERISA Policy, Costs, and Attorneys' Fees.

In a recent case, Marcin v. Reliance Standard Life Insurance Company and Mitre Corporation Long Term Disability Insurance Program, No. 16-7125, __F.3d__, 2017 WL 2818648 (D.C. Cir. June 30, 2017), the Court of Appeals for the District of Columbia, ruled against Reliance Standard Life Insurance Company and upheld an award of benefits, costs, and attorneys' fees under an ERISA governed disability insurance policy for a claimant, Jill Marcin. Ms. Marcin suffers from multiple medical conditions including kidney cancer, portal vein thrombosis, Factor V Leiden (a mutation of one of the clotting factors in the blood called factor V which, increases the chance of developing abnormal blood clots, usually in the veins - including pulmonary embolisms), splenorenal shunt, polycystic ovarian syndrome, and anemia.

Federal District Court Finds that Hartford Failed to Provide a Claimant with a Full and Fair Review of her ERISA Governed Disability Insurance Claim.

In a recent case out of the Southern District of Indiana, Miller v. The Hartford Life And Accident Insurance Co., & Springleaf Finance, Inc. Disability Plan, No. 116CV00166TWPDML, 2017 WL 2214938 (S.D. Ind. May 19, 2017), the federal court found that Hartford failed to afford the Plaintiff a full and fair review of her ERISA governed disability insurance claim and remanded the matter back to Hartford to reevaluate the claim.

DI Law Group Sponsors the 2017 Celebrating everyBODY Walk supporting the Alliance for Eating Disorder Awareness.

DI Law Group was proud to sponsor the 2017 Celebrating everyBODY Walk, held by the Alliance for Eating Disorders Awareness. The purpose of the Walk is to foster awareness and understanding of and promote early intervention of eating disorders. As always, DI Law Group was honored to be a part of this inspiring and uplifting event. The Alliance for Eating Disorder Awareness provides free presentations, support groups for individuals and their families who are struggling with eating disorders, and publishes an annual national and local guide to treatment facilities. DI Law Group looks forward to sponsoring the Walk in the years to come and to continuing to support the vital work of the Alliance for Eating Disorders Awareness.

Reliance Standard Life Insurance Company Denial Tactics Dismissed By Court in ERISA Disability Case

Most individuals who have filed any type of insurance related claim have experienced the delay and denial tactics used by their insurance company to avoid payment. Disability carriers often take extreme and arguably egregious measures to "prove" that a claimant is not disabled under the terms of their disability policy. In a recent case, the US District Court for the Northern District of California found Reliance Standard Life Insurance Company's (RSL) denial of benefits wrong and ordered the company to reinstate the Plaintiff's benefits.

Seventh Circuit Upholds District Court's Decision that a Claimant with Fibromyalgia was Disabled under her ERISA Governed Disability Plan and Commented on the Disabling Nature of Fibromyalgia.

In a recent case, Kennedy v. The Lilly Extended Disability Plan, No. 16-2314, __F.3d__, 2017 WL 2178091 (7th Cir. May 18, 2017), the Seventh Circuit Court, overturned a disability insurance benefit denial of a claimant with fibromyalgia. The claimant in the Kennedy case was the executive director of Lilly's human resources department, earning a monthly salary of $25,011. Kennedy was diagnosed with fibromyalgia and was suffering from its severe symptoms. Ultimately, she was unable to continue to work and filed a claim for disability benefits under Lilly's self-funded ERISA governed disability plan. Originally, Kennedy's claim was approved and she received benefits for over three years. However, the plan required Kennedy to undergo a physical evaluation over 100 miles from her home by a physician it hired. The "examination" lasted a mere five-minutes. The plan also hired a rheumatologist to conduct a records review of Kennedy's medical information, who falsely alleged that the American
College of Rheumatology does not consider fibromyalgia to be disabling on an extended basis. Based on the opinions of these two physicians, the plan terminated Kennedy's benefits.

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