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Ortiz Law Firm | National Disability Law Firm
Ortiz Law Firm is dedicated to helping people recover the disability benefits they deserve. We handle group Long Term Disability (LTD) claims, individual disability insurance policy claims, ERISA disability claims, and Social Security Disability claims.
The case involves a dispute over long-term disability (LTD) benefits between Geiger, the claimant, and Zurich American Life Insurance Company of New York (“Zurich”), the administrator of an ERISA-regulated benefits plan. Background Geiger worked at CBS News in New York as a writer/editor. In March 2018, at the age of 58, Geiger could …
The plaintiff, Sutton, filed a lawsuit against MetLife, the defendant, for the wrongful denial of long-term disability benefits under his employer’s plan governed by ERISA (Employee Retirement Income Security Act). Background Under the disability plan’s policy documents, if an employee’s disability is attributable to a neuromuscular or …
Recently, we appealed a claim denial issued by The Standard. The claim had been denied because the insurance carrier had determined that the claimant’s condition was caused or contributed to by a pre-existing condition. This is not an unusual basis for a long-term disability claim denial. However, upon further review, we determined this …
In Gregory Cannon v. Aetna, a pharmacist challenged Aetna’s denial of short-term disability benefits, arguing the insurer ignored his symptoms, failed to follow internal procedures, and overlooked his Social Security approval. The court sided with Aetna, finding no abuse of discretion and concluding Cannon failed to provide sufficient objective …
In Dardick v. Unum Life Insurance Company of America and First Unum Life Insurance Company, Unum succeeded in denying the claimant long-term disability insurance benefits. Dardick filed a lawsuit after Unum Life Insurance Company of America denied his claim for benefits under a group disability benefits plan provided by his previous …
Plaintiff appealed the initial denial of benefits under the Plan, stating that her request for disability was not based solely on her thyroid surgery but rather on symptoms associated with lupus and chronic pain. On September 12, 2011, ALIC again upheld the denial of benefits to the Plaintiff. As allowed under ERISA, the Plaintiff sued to challenge …
In this case, the Court found that the Plaintiff's complaints of pain were credible there was no reason to question the Plaintiff's credibility. As such, the Defendants' motion for decision was denied and Plaintiff's motions was granted.
Today we review Abrams v. Unum Life Insurance Company of America that was decided by the United States District Court for the Western District of Washington. William Abrams was a trial and appellate lawyer for the Schwabe Law Firm. His disabilities were described as debilitating symptoms from an illness. Although the exact medical condition was …
In this case, the claimant won a reinstatement of his long-term disability insurance benefits in the United States District Court for the District of Colorado. The Plaintiff’s Medical History and Claim History: Mr. Paquin worked for Transistor Devices, Inc. as a Business Development Director. In 2003, Mr. Paquin contracted encephalitis from a …
Plaintiff Laverne Robinson brought a lawsuit against Aetna Life Insurance Company (“Aetna”) and Mondelez Global LLC Employee-Paid Group Benefits Plan (“the Plan”) for unpaid long-term disability (“LTD”) benefits under the Employee Retirement Income Security Act of 1974 (“ERISA”). Robinson was a former utility machine …
On April 7, 2023, the United States District Court for the District of Massachusetts decided an ERISA long-term disability insurance case against the Unum Insurance Company of America. The Court ruled in favor of Unum. The claimant worked with Symbiotic LLC Plan as the Director of Software Quality Assurance. He had worked in the computer …
Today we review Arenson v. First Unum Life Insurance Company that was decided by the United States District Court for the Northern District of Illinois. Gregg Arenson was a futures and options trade broker. He sued his former employer’s benefits administrator, First Unum Life Insurance Company (hereinafter “Unum”) under ERISA. He …
Unum paid long-term disability (LTD) insurance benefits to Susan Moseley, but stopped paying after a period of time pursuant to the mental illness limitation in her long-term disability policy (a policy is also called a “plan” of benefits). Moseley appealed the case all the way to federal court, arguing that Unum abused its discretion …
Jonni Marselle was covered for long-term disability (LTD) benefits under a group plan provided to Humana, Marselle’s former employer. Marselle was a consultant with Humana. The position was sedentary as it required her to constantly sit, occasionally stand, and occasionally walk. She mostly did computer work. Her disabilities included …
I’ve been away from case summaries for a bit. Going to turn that around with a recent decision in Foss v. Standard Insurance Company, Case No. 20-cv-2449, decided by the United States District Court for the District of Minnesota on August 19, 2022. Unfortunately, the Court ruled in favor of the insurance company. Plaintiff Caroline …
Ms. Fowkes does not contend the Plan’s written evidence requirement violates ERISA. Instead, she takes issue with MetLife's procedures to evaluate her LTD claim. In particular, she contends MetLife required her to present “objective evidence” supporting her LTD claim. At the hearing, she argued that MetLife did not consider the cumulative effect of …
The claimant in Archer v. Hartford Life and Accident Insurance Company was an Assistant Store Manager at TJX Marshall’s Department Store. She had group long-term disability (LTD) coverage. She also had life insurance benefits. Both of these categories of group benefits were issued and administered by Hartford. Hartford had what we call …
In Cassidy v. Aetna Life Insurance Company, the U.S. District Court for the Eastern District of Kentucky ruled in favor of Aetna in a long-term disability insurance claim. The decision was issued on May 21, 2021. The long-term disability insurance claim was governed by the Employee Retirement Income Security Act of 1974 (ERISA). Ms. Cassidy …
Mr. Calkin was a 65-year-old manager of architectural design for AIG from June 10, 2013, through June 24, 2014. Mr. Calkin suffered from impingement syndrome in his left shoulder, brachial plexopathy (a form of neuropathy), bilateral shoulder pain, lower back pain due to degenerative disc disease and stenosis in his lumbar …
Ms. Harrison was a claimant who worked as a customer service representative for a cash advance lender. Her duties included selling financial products to customers, providing customer service, handling money, and overseeing financial transactions. She also suffered from depression and anxiety during her time at this place of …
In this case, Tommy W. Senegal (“Senegal”) had a long-term disability policy that was administered by Reliance Standard Life Insurance Company (“Reliance Standard”) as a benefit of his employment by Cequel III, LLC (“Cequel”). Senegal worked for Cequel as a field service engineer; his duties were specifically related to supervising cable …
Marybeth M. Donlick (“Donlick”) was employed as a truck driver for Chesapeake Energy Corporation (“Chesapeake”). Through her employment, Donlick received coverage for a long-term disability benefits plan, which was administered by Standard Insurance Company (“Standard”). On August 7, 2012, Donlick was in a motorcycle crash which caused her to have …
In this case, David Diaz (“Diaz”) was the district manager at JM Family Enterprises, Inc. (“JM Family Enterprises”) between September 2010 and October 2015. JM Family Enterprises’ had an employee benefit plan which covered long-term disability benefits. This plan was insured by Liberty Life Assurance Company of Boston (“Liberty”). Under the plan, …
Carianne Deroo (“Deroo”) worked as an employee for Beaumont Hospital as a Clinical Nurse II. This role involved full-time work as a registered nurse which required patient care. Through her employment with Beaumont Hospital, Deroo was covered by a long-term disability benefits policy which was administered by Unum Life Insurance Company of America …