Frankel & Newfield, P.C.

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November 2012 Archives

Court Determines Aetna Failed to Appropriately Consider Impact of Pain

A Federal Judge has denied Aetna's efforts to dismiss a challenge to its claim determination in a long term disability insurance claim, finding that Aetna failed to properly consider the functional limitations of an insured, whose long term disability insurance claim was terminated after being paid for several years under the policy.

Jason Newfield Receives AV Preeminent® Peer Review Rated from Martindale Hubbell®

After an extensive and confidential peer review, Jason Newfield has received an AV Preeminent® Peer Review Rated rating from Martindale-Hubbell®, the highest level of rating that can be attained. Jason's superior representation of clients has placed him among a select group of attorneys, and we congratulate him on this well-deserved recognition.

Lincoln Terminates Disability Benefits, We Win ERISA Appeal

The Lincoln Financial Group abruptly terminated our client's long term disability benefits during the "own occupation" portion of her claim. A 55 year old woman who previously worked as a manager of a nursery, which required a fair amount of physical labor as well as managerial abilities, she suffered from severe orthopedic difficulties which required multiple surgeries. There had not been any change in her condition, so the termination made no sense and only added to the hardships that she was experiencing. Frankel & Newfield was retained to represent her in an ERISA long term disability insurance appeal.

PRUDENTIAL ABUSED ITS DISCRETION IN DENYING CLAIM FOR LONG TERM DISABILITY BENEFITS

A Federal Judge has determined that Prudential abused its discretion in denying the long term disability insurance claim of a claimant with numerous orthopedic injuries. The long term disability insurance claim had not been approved, on the basis the claimant failed to provide records demonstrating restrictions or limitations in her ability to work. On appeal, the claimant submitted medical support including an articulation of restrictions and limitations; however, Prudential's hired doctor, who performed only a paper review of the medicals, determined that some limitations were supported, but were not significant enough to impair the claimant from full time sedentary work.

Reverse ERISA Appeal When Standard Denies Claim by C-Level Executive

Our client was a C-level executive with a Fortune 500 company who suffered from several co-morbid disabilities following a serious car accident. Because she was relatively young - 45 - we know that Standard Insurance claim personnel were calculating the total benefit payout and trying to avoid a high six or even seven-figure liability on their balance sheets.

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