The Disability Application

In Brasseur v. Life Insurance Company of America (LINA), Plaintiff Wilfred Brasseur, a computer engineer, worked in the Houston office of Chicago Bridge & Iron Company when he became disabled. LINA denied his application for long term disability benefits on the grounds that he “was not disabled as defined by the Plan’s terms.” Ultimately, Brasseur filed an ERISA lawsuit in Houston. He filed a motion for summary judgment limited to the issue of what standard of review should apply to the court’s evaluation of his claim. He argued that since the Plan was issued in Chicago, Illinois, Illinois law should apply. This would subject his claim to do novo review instead of the abuse of discretion standard. The Texas District Court agreed with the plaintiff, holding that it would review Brasseur’s claim using the plaintiff preferred de novo standard instead of the defendant preferred abuse of discretion standard.
Read more »

In Cheney v. Standard Insurance Company and Long Term Disability Insurance, the Seventh Circuit Court of Appeals dealt with an issue concerning when the last day was that the plaintiff actually worked in order to determine whether or not she was covered under Standard’s long term disability policy. The question was a complicated one since this plaintiff, an attorney, worked some of the time at home, took long vacations, and also took extended leaves of absence to flirt with a career in politics. The Seventh Circuit remanded to the Illinois district court since “the district court had made no explicit finding about the onset date of Cheney’s long-term disability.” The last day she worked as well as the date upon which she became disabled are crucial questions that must be answered in order to determine if she had coverage under the policy.
Read more »

Hogan v. Jacobson et al., is case where, after plaintiff Violet Hogan lost her lawsuit for disability benefits against Life Insurance Company of North America (LINA) in federal court, she filed a lawsuit in state court against two of LINA’s nurses. In her attempt to avoid any reference to her previously unsuccessful lawsuit brought under the Employment Retirement Income Security Act (ERISA), she filed suit in state court and “artfully pleaded” a case for negligence per se against LINA nurses Jo Ellen Jacobson and Kem Alan Lockhart. Hogan claimed the two nurses gave medical advice without being properly licensed in Kentucky. The defendants removed the case to federal court. Hogan objected and moved for the case to be remanded to state court. Her motion was denied, her lawsuit dismissed, and this appeal followed.
Read more »

Dowdy v. Metropolitan Life Insurance Company (MetLife) is a sad case for plaintiffs who have a pre-existing condition that contributes to their otherwise qualifying event for collecting insurance benefits. Thomas Dowdy and his wife had purchased an accidental death and dismemberment policy through Mrs. Dowdy’s employment at Bank of the West.
Read more »

Clark v. Cuna Mutual Long Term Disability Insurance is a plaintiff friendly case where a Wisconsin federal district court found that CUMA “acted arbitrarily and capriciously in denying Clark benefits.” Clark was employed by CUNA for 21 years as a “Retirement Education Specialist, Virtual” before he became disabled in 2006 after injuring his back while moving a heavy couch. He reinjured his back in 2007 when he tried to save a swimmer from drowning. He was granted short term disability benefits. After being denied long term disability benefits and exhausting his administrative remedies, Clark filed this ERISA lawsuit.
Read more »