In this 2023 ERISA case, the Defendant ceased providing disability benefits to the Plaintiff pursuant to a mental illness limitation of her long-term disability policy. The Plaintiff challenged this decision, arguing that the Defendant abused its discretion by finding that the basis for her disability is psychological rather than physical. The Defendant moved for summary judgment. The Court examined the record and immediately notes that the Defendant failed to provide the Plaintiff with an independent medical examination (IME) when she requested it, and that constituted a procedural error and rendered the Defendant’s benefits determination inherently arbitrary and capricious. For this reason, the Court denied the Defendant’s motion for summary judgment and remanded the case for an IME to be conducted.
If you need assistance navigating your claim for short term or long term disability benefits under ERISA, or it is time to sue the insurance company, please do not hesitate to give Cody Allison & Associates, PLLC a call (844) LTD-CODY, (615) 234-6000. or send us an e-mail Cody@codyallison.com. We provide representation nationwide and have successfully sued all the major insurance companies in many states. Our headquarters are located in Nashville, Tennessee. We offer a free consultation and would love to speak with you.
Latest Posts
Check Your ERISA Plan Statute of Limitations Language
As with any area of the law, the statute of limitations is of utmost importance in ERISA plans. A statute of limitations is a barrier in the law or in the...
ERISA Conflict: Summary Plan Description (SPD) v. Policy Language
One of the biggest problems you may encounter with making a long-term disability claim is the actual policy language versus the summary plan description....
LTD Delay………..
Below is a discussion of the problems associated with making a claim when suffering from CFIDS. Making such a long term disability claim can be very...