The Chartwell Chronicles: Permanent Disability
Physician Employment Agreements: Focus on Financial Planning
An Overview of New Jersey Workers' Compensation
An Overview of Massachusetts Workers' Compensation
Workers' Compensation Academy: Requests by Defense Counsel – A Defense Analysis of Materials Needed from Carriers and Clients for NJ Workers' Compensation Claims
An Overview of New York Workers' Compensation
Workers' Compensation Academy: Pennsylvania COVID-19 Update: Layoff or Furlough from Light Duty as a Result of COVID-19
This month’s Friday Five examines recent court rulings on both short- and long-term disability benefits, focusing on key interpretations—including how "earnings" are defined under an employer’s plan....more
This month’s Friday Five explores decisions from around the country discussing the concept of reasonableness in various forms. One court rejected the parties’ proffered definitions of the term “working” and instead determined...more
The April Friday Five covers cases determining futility of exhausting administrative remedies, the nuances of the pre-existing condition exclusion, ERISA preemption, and genuine issue of material fact over an employee’s...more
This month’s Friday Five explores decisions addressing the burden of proving accidental death, policy language and “any occupation” disability, an interpleader case where the insurer was not dismissed from the case, the...more
Life Policy Lapse Shortly Before Insured’s Death - In Simon v. USAA Life Insurance Co. (Mar. 29, 2024), the insurer denied death benefits under a term life insurance policy, which had lapsed for nonpayment of premium two...more
Jason Brand made a claim for disability benefits under his disability policy with Principal Life Insurance Company on the basis that he was totally disabled by extreme anxiety that began in July 2014 after a warrant was...more
This month’s Friday Five explores recent decisions that range from the effect on disability benefits when medical records are not provided after two appeals, to a case that examines how an award of death benefits is...more
This month’s Friday Five addresses two cases involving disability claims that touch on Covid-19, a Circuit Court ruling for an insurer, a district court ruling that a 20-year-old regulatory settlement precluded an insurer...more
Seyfarth Synopsis: The 7th Circuit recently held that insurers and administrators must provide claimants an opportunity to respond to new information relied on for adverse benefit determinations, even if the claim predated...more
This month’s Friday Five covers cases relating to: (1) whether claim administrators can recover overpayments through a breach of contract claim under state law; (2) whether claim administrators can rely solely on a claimant’s...more
Register Today For Cranfill Sumner’s 2021 Virtual Continuing Education Seminar: Workers’ Compensation & Civil Litigation Law Updates...more
In recent months, circuit courts across the country have supported insurers’ discretion to deny long-term disability benefits (LTD) under ERISA. Since the beginning of the year, disability plan insurers have prevailed in the...more
A federal court in New York recently construed the meaning of a total disability definition where the insurance policy language includes residual disability coverage. The January 3, 2020 decision came from the U.S. District...more
Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more
The Award - In McClure v. CC Services Inc. & Country Life Insurance Company dba Country Life Financial, an Arizona insurance bad faith case arising from a disability claim, a jury awarded $1.29 million in compensatory...more
Even when a claims administrator approves a claim for disability benefits, its job is not done. That principle was again demonstrated in the recent case Owings v. United of Omaha Life Insurance Co., No. 16-3128 (10th Cir....more
The U.S. Court of Appeals for the Second Circuit has ruled that New York’s anti-subrogation statute, N.Y. Gen. Oblig. Law § 5-335(a), applies both to “offsets” for prospective benefit payments and to reimbursements for prior...more
Seyfarth Synopsis: In a strong decision for insurers, the Eighth Circuit affirmed summary judgment for the administrator, rejected plaintiff’s conflict of interest argument, and found that it was not arbitrary for the...more
In This Issue: - IN THE SPOTLIGHT • Risky Business: Common Cyber Security Risks, Expensive Consequences - LIFE INSURANCE • Ninth Circuit Finds Bonus Indexed Annuity Delivers Exactly...more
The U. S. Court of Appeals for the Sixth Circuit, sitting en banc, has overturned the decision of a divided three-judge Sixth Circuit panel which had affirmed the district court’s award of $3.8 million of “disgorged” profits,...more