Our client was a financial analyst for a large defense contractor. She had to stop work due to severe symptoms related to her diagnosis of Lupus. Lupus is an autoimmune disease in which the immune system attacks one’s own body. Our client was treated with medication to suppress her immune system, which exposed her to other illnesses and infections which her suppressed immune system could not fight. Read more
The Ninth Circuit Court of Appeals found that CIGNA‘S decision to deny disability benefits to a claimant with chronic fatigue was illogical, implausible and without support because:
- Every doctor who personally examined the insured concluded that he was disabled;
- The Plan Administrator demanded objective tests to establish the existence of a condition for which there are no objective tests;
- The Administrator failed to consider the Social Security Disability Award;
- The reasons for denial shifted as they were refuted, were largely unsupported by the medical file, and only the denial stayed constant;
- The Plan Administrator failed to engage in the required “meaningful dialogue.”
The Court confirmed that Read more
The City of San Diego provides Disability Retirement Plans to employees that differ from private sector plans. San Diego City employees are provided with two levels of Disability Insurance Benefits:
- Industrial Disability Retirement – If your disability is work related, you are entitled to greater benefits from the date of disability regardless of your age.
- Non-Industrial Disability Retirement – If your disability is not related to your employment, you are entitled to benefits beginning at age 55.
The criteria for a member to be considered for Industrial Disability Retirement is to be permanently incapacitated by bodily injury or illness caused by their job; are unable to perform the usual duties of their job; and are required to retire. If awarded, an industrial disability retirement benefit is the higher of the following amounts:
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On November 9, 2010, the United States District Court for the Southern District of Ohio held in the case of Mennucci v. Hartford Life & Accident Insurance Company that Hartford abused its discretion in terminating Ms. Mennucci’s disability benefits. Ms. Mennucci underwent spinal fusion surgery for cervical neck pain that radiated into her right arm. Hartford initially paid short term and long term disability benefits to Mennucci. However, when she failed to fully recover from her surgery and complained of continuing neck pain radiating into her right shoulder Hartford Insurance terminated her benefits based on a medical record review by Dr. Richard Kaplan.
Courts across the country have struggled with whether an accidental death insurance policy covers the death of a drunk driver. Some courts have ruled that intoxicated drivers knowingly increase the risk of being involved in a fatal accident to the point that their death becomes foreseeable and thus, not accidental. Other courts disagree, citing the fact that there is less than a 1% chance of an intoxicated driver being involved in a fatal accident.
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