Life Insurance Company of North America (LINA)

The plaintiff, Heath Evans, was employed by Schlumberger Technology Corporation. Evans worked as a wireline operator, a role the Department of Labor classified as requiring very heavy physical labor. Evans suffered a workplace injury to his back in November 2013, leading to significant back pain and functional limitations. He underwent two …

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.

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, the medical reports in the administrative record were not sufficient to show by a preponderance of the evidence that Shaw was unable to perform the material duties of her regular occupation. The only reports that supported her claim were conclusory, and provide insufficient information concerning Shaw’s functional capacity.

Defendant informed Plaintiff that her claim for LTD benefits was denied because the medical information provided did not support restrictions and limitations and did not demonstrate a functional loss. The plaintiff argued that she was not required to submit objective medical evidence to prove her disability.

The Court held that Life Insurance considered all relevant information, including Abbey’s treatment notes, treatment notes from Plaintiff’s treaters at Philhaven, and the notes from the board-certified psychiatrist based on his peer review of Plaintiff’s medical records. The Court concluded that in light of the foregoing thorough review and …

In this case, the court ruled that the conclusion by the peer review consultant was without reason when the evidence of record was examined. Thus, defendant acted arbitrarily and capriciously when relying on the peer review report to deny benefits.

Here, Chernequa Dawson (“Dawson”) worked as a Care Transition Coordination (“CTC”) Nurse Care Manager and was employed by Cigna Corporation (“Cigna”). Through her employment with Cigna, she was covered under both a short-term and long-term disability plan. For these plans, Cigna pays the short-term disability plan benefits, …

Because the record establishes that LINA acted arbitrarily and capriciously in denying Calhoun long-term disability benefits, the Sixth Circuit REVERSED the district court’s judgment and REMANDED this case to the district court.

In Burkhead v. Life Insurance Company of North America, the plaintiff filed for short and long-term disability benefits from Life Insurance Company of North America (LINA), the insurer of her ERISA governed plan. In the District Court’s Opinion, the court held that LINA abused its discretion in denying plaintiff benefits under the “own occupation” …