Ninth Circuit Reverses Denial of Health Benefits, Finding UnitedHealthcare Abused Its Discretion by Stonewalling Claimant with Cookie-Cutter Denial Letters and Failing to Produce the Claim File for Over Three Years
Ninth Circuit Reverses Denial of Health Benefits, Finding UnitedHealthcare Abused Its Discretion by Stonewalling Claimant with Cookie-Cutter Denial Letters and Failing to Produce the Claim File for Over Three Years
In Campbell v. UnitedHealthcare Insurance Co., No. 24-5736, No. 25-758, 2026 WL 982848 (9th Cir. Apr. 13, 2026), a Ninth Circuit panel composed of Circuit Judges Tallman, VanDyke, and Tung…
Can Insurance Companies Surveil You During an ERISA Disability Claim?
Summary: Yes. Under ERISA, insurance companies can and do monitor social media and conduct in-person surveillance of long-term disability claimants. A single photo, post, or video clip — even taken…
Massachusetts District Court Awards LTD Benefits to Claimant with Dysautonomia, Finding Insurer Failed to Prove Mental Health Limitation Applied Under But-For Causation Standard
In DeMario-Miko v. United of Omaha Life Insurance Company, No. 1:24-cv-11058-IT, 2026 WL 948948 (D. Mass. Apr. 8, 2026), the United States District Court for the District of Massachusetts granted…
Sixth Circuit Holds ERISA Preempts Tennessee PBM Laws Restricting Pharmacy Network Design and Cost-Sharing Arrangements
In McKee Foods Corporation v. BFP Inc., No. 25-5416, --- F.4th ----, 2026 WL 936759 (6th Cir. Apr. 7, 2026), the Sixth Circuit Court of Appeals held that ERISA preempts…
Sun Life Defeats LTD Claim as Time-Barred: How a Policy’s Choice-of-Law Clause Determined the Limitations Period
In Gordon v. Sun Life Assurance Co. of Canada, No. 2:25-CV-11132-TGB-KGA (E.D. Mich. Mar. 31, 2026), United States District Judge Terrence G. Berg granted Sun Life's motion to dismiss an…
Unum’s Denial of LTD Benefits for CBS News Producer with Long COVID Survives Summary Judgment — But So Does Her Claim
A federal district court in the Southern District of New York denied both parties' motions for summary judgment in DelValle v. Unum Group Corp., First Unum Life Insurance Company, No.…
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