Calling In a Disability Expert

Arthur Fries, an independent disability consultant and an expert I have known for many years, has written an article entitled “Calling In a Disability Expert” which appeared on November 16, 2009 in the National Underwriter.  Insurance consumers and consumer attorneys should review this article.  He posits that insurance consumers should hire consultants and/or attorneys with …

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Guardian to Offer Guaranteed-Issue Small Group Disability Income Insurance

According to National Underwriter, Guardian Life Insurance Company of America is making it easier for employers with 2 to 9 employees to offer disability insurance benefits.  It says it now will let employers in that size range provide disability insurance on a guaranteed issue basis.  The guaranteed issue provision lets employers provide employees with some …

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Court of Appeal Complicates the Analysis of Mental and Nervous Disability Claims

Bosetti v. The United States Life Ins. Co., 175 Cal. App. 4th 1208 (2009) is an important California Court of Appeal decision that addressed whether a two-year benefits limitation on disabilities due to “mental, nervous or emotional disorder[s]” could serve to limit benefits payable to an insured disabled from depression and anxiety who also complained …

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“Top Hat” ERISA Plans Are Not Entitled To Special Treatment

The Ninth Circuit recently addressed, for the first time, whether the standard of review analysis for “top hat”ERISA plans is the same as for other ERISA plans. InSznewajs v. U.S. Bancorp Amended and Restated Supplemental Benefits Plan, 572 F.3d 727 (9th Cir. 2009), Franciene Sznewajs, the ex-wife of co-defendant Robert Sznewajs, challenged the Plan’s decision …

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Ninth Circuit Clarifies Application of Abuse of Discretion Review When Insurer Has a Conflict of Interest

After the United States Supreme Court decided MetLife Ins. Co. v. Glenn in which the Court held that a reviewing court must consider the conflict of interest arising from the dual role of an insurer acting as a plan administrator and payor of plan benefits as a factor in determining whether the insurer abused its …

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Under Abatie, Discovery of Profitability Reports is Not Allowed

One of the most interesting questions in ERISA litigation is: What constitutes the administrative record for purposes of determining whether the administrator abused its discretion in making a claim determination?  Bartholomew v. Unum Life Ins. Co., 579 F. Supp. 2d 1339 (W.D. Wash. 2008) helped answer this question. Plaintiff, who sued to recover benefits under …

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Council for Disability Awareness Follows Approvals of Disability Claims by the SSA and Private Disability Insurers

Allison Bell of the National Underwriter reported on September 11, 2009 that approved disability claims rose more quickly in 2008 at the Social Security Disability Insurance program than at private disability insurers. She explained that the Council for Disability Awareness in Portland, Maine reported that findings in a summary of results from an analysis of …

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