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Appealing A Claim Denial

The Southern District of Florida Finds that the PNC Plan Fails to Properly Delegate Discretion to Liberty Life Assurance Company and Finds that the Plan’s Denial of Benefits to a Branch Manager Disabled by Degenerative Disc Disease Was Wrong

In a recent case out of the Southern District of Florida, the district court held that while the PNC Plan provided PNC with discretion to determine questions of coverage and eligibility for benefits, there was not a proper grant of discretion to the third-party...

Eleventh Circuit Court of Appeals Finds that Reliance Standard Life Insurance Company Acted Unreasonably When it Denied Disability Insurance Benefits Under the Pre-Existing Condition Exclusion to a Woman Who Suffered a Stroke Nine Days After Giving Birth

Julissa Bradshaw had a healthy pregnancy and no other pre-existing medical conditions when she became insured under her ERISA governed disability insurance policy with Reliance Standard Life Insurance Company ("RSL"). Approximately six months after obtaining the...

The First Circuit Court of Appeals Determines that Standard Insurance Company Acted Unreasonably Denying a Claimant Benefits, Where it Failed to Consider the Claimant’s Actual Occupational Duties.

In a recent case, the First Circuit Court of Appeals determined that Standard Insurance Company acted arbitrarily and capriciously when it denied an environmental attorney with severe depression Long-Term disability insurance benefits. The claimant was an equity...