Successful Cases

At Eric Buchanan & Associates, our team has helped many people fight denials of disability insurance, ERISA insurance, and similar insurance claims. Here is a sample of our successful cases.

 

Back injury:

 
Our Client v. Life Insurance Company of North America 

486 F.3d 157 (6th Cir. 2007).

Our client, an insurance claims adjuster for ACE Insurance, became disabled from a back injury after working for ACE for twenty-one years.  Throughout the administrative appeals process, Life Insurance Company of America (LINA), ACE’s claims administrator, denied our client’s claim on the basis that her medical records did not contain sufficient evidence of her functional limitations to meet the definition of “disability” in the long-term disability plan.  However, the court held that LINA had acted arbitrarily and capriciously by ignoring the notes and tests provided by her treating physicians that did limit our client’s functional abilities and by instead crediting the opinions of hired file reviewers who never discussed our client’s condition with her treating physicians and unreasonably discredited medical evidence supporting our client’s disability.

Court-awarded attorney’s fees:

 
Our Client v. Life Insurance Company

No. 1:05-CV-111, 2008 WL 819990 (E.D.Tenn. Mar. 25, 2008).

After arguing the substantive issues of this case in the Sixth Circuit, the Sixth Circuit remanded this case to the District Court to award retroactive benefits and other relief as appropriate.  The District Court then granted our petition for $42,815.00 in attorney’s fees and $250.00 for reimbursement of the client’s court-filing fee.

Depression, panic attacks,  bi-polar disorder:

 
Our Client v. Bayer Corporation Long Term Disability Plan

275 Fed. Appx. 495 (6th Cir. 2008) (Unpublished).

Our client, the plaintiff in this case, was a pharmaceutical sales representative for Bayer Corporation until he had to quit working due to depression, panic attacks, and bi-polar disorder.  Both of our client’s treating physicians supported that his mental conditions prohibited from returning to work as a pharmaceutical sales representative.  However, Bayer relied on the opinions of its hired experts to deny our client’s claim for benefits.

The district court held that this denial was arbitrary and capricious and that our client was entitled to benefits.  Bayer appealed, and we pursued our client’s claim to the Sixth Circuit.  The Sixth Circuit agreed with us that our client was unable to perform his regular occupation with Bayer, and that Bayer’s reliance on the opinions of experts who had never met our client in person was improper when those opinions contradicted the opinions of his treating physicians.  The court declared, “Given th[e] obvious shortfall in the analytical framework used by the experts credited by the plan administrator, in conjunction with the numerous factual errors, misunderstandings, and analytical omissions of those persons reviewing the findings of our client’s treating psychiatrists, the administrative record contained no reliable evidence to support the conclusion that [our client] was competent to return to his previous occupation.”

Back Pain:

 
Our Client v. United of Omaha Life Insurance Company

938 F. Supp. 2d 736 (W.D. Tenn. 2013).

After a year of increasing back pain, our client had to leave her job as a legal assistant.  After paying our client short-term disability benefits for the maximum amount of time, United of Omaha denied our client’s claim for long-term benefits.  Relying on the opinions of three file reviewers who had not conducted physical examinations of our client, Omaha denied her claim.  The court held that Omaha’s reliance on these file reviews was arbitrary and capricious under the circumstances, because Omaha had failed to exercise its right to conduct a physical examination and because the file reviewer’s reports contained only conclusory statements not supported by evidence.  The court remanded our client’s claim to Omaha to conduct a fair evaluation of its merits.

Gorlin’s Syndrome, skin cancer:

 
Our Client v. Hartford Life & Accident Insurance Company

517 Fed. Appx. 475 (6th Cir. 2013) (Unpublished).

After working for Navy Federal for thirty-two years, our client had to stop working due to Gorlin’s Syndrome, a rare genetic defect that caused him to develop numerous skin cancers which had to be removed.  By September of 2007 our client was having such frequent procedures that he could no longer remain employed, so he filed a claim for long-term disability benefits.  Hartford originally awarded our client benefits but later terminated his benefits when Navy Federal allowed our client to work from home.  our client appealed, arguing that he was unable to even work from home due to the frequency of his surgeries and the accompanying recovery time.

Hartford relied on the opinion of a file-reviewing expert that our client would require three to four days to recover from each surgery, despite our client’s treating dermatologist opining that he would need a week to recover.  Additionally, Hartford determined that the amount of time our client would be unable to work while recovering was not frequent enough to preclude work; however, in calculating how often our client had surgeries, Hartford reviewed our client’s prior history and included months during which our client did not claim to be disabled and was still working.

Hartford also relied on the opinion of a file-reviewing physician who tried to speak with our client’s treating doctor, but was unable to reach him.  When the treating physician later provided information that contradicted Hartford’s file-reviewing doctor, Hartford erroneously continued to rely on the file reviewing doctor’s opinion.

Finally, Hartford’s vocational expert declared that “the common practice of employers” regarding sick days would accommodate our client’s frequent absences but did not cite to any national data or information from Navy Federal.  The court held that Hartford’s denial was arbitrary and capricious, because Hartford did not have sufficient evidence that our client’s recovery time was only three to four days, did not accurately calculate the frequency of our client’s surgeries, and relied on the vocational expert’s opinion that did not cite any evidence or data.

Life Insurance, Breach of Fiduciary Duties, ERISA Fiduciary:

 
Our Client v. Sun Life Assurance Company of Canada

Order on Remedies, No. 3:13-CV-0612, 2014 WL 7156517 (M.D. Tenn. Dec.15, 2014); Order adopting R&R, No. 3:13-CV-0612, 2014 WL 4979335 (M.D.Tenn. Oct. 6, 2014); and Report and Recommendation, No. 3:13-CV-0612, 2014 WL 4053389 (M.D.Tenn. Aug. 15, 2014).

In this case, an employer allowed an employee to enroll in significantly more life insurance than the employee qualified for.  When the employee was later killed, we successfully argued that her surviving children should be awarded the full amount of life insurance that was promised, an additional $784,000.

[The district court chose not to officially publish this case, but it is available on Westlaw. The important information about the decision is  found throughout three decisions on Westlaw.  First, the district court judge assigned a magistrate judge to write a recommended decision, called a “Report and Recommendation” or “R&R.”  The R&R contains most of the information about the basic facts and recommends that our client’s claim for the greater benefits be granted.  *redacted* v. Sun Life Assur. Co. of Canada, Report and Recommendation, No. 3:13-CV-0612, 2014 WL 4053389 at *1-2 (M.D. Tenn. Aug. 15, 2014).  The court’s official decision in favor of our client’s claim is the decision of the district court judge, The district court judge’s opinion is the official decision, but it does not contain all the factual details found in the R&R.  *redacted* v. Sun Life Assur. Co. of Canada, Order adopting R&R, No. 3-13-0612, 2014 WL 4979335 at *2 (M.D. Tenn. Oct. 6, 2014).  After finding in our client’s favor, the court invited another round of briefing on the remedy available for the client’s family and issued another order granting the claim for the full amount of life insurance promised.  *redacted* v. Sun Life Assur. Co. of Canada, Order on Remedies, No. 3-13-0612, 2014 WL 7156517 at *2 (M.D. Tenn. Dec. 15, 2014)].

Cerebral hemorrhage, bleeding in the brain, stroke; life insurance, life waiver of premium, coverage if insurance company changes while a person is disabled:

 
Our Client v. Sun Life Assurance Company

345 Fed. Appx. 161 (6th Cir. 2009) (Unpublished).

We helped our client obtain life insurance benefits under a policy that allowed him to keep his life insurance if he had been disabled when he stopped working. Our client became disabled due to a cerebral hemorrhage, or a stroke, that caused him to have to stop working.  He tried to come back to work but was unable to fully perform his job, and he stopped working entirely after a few months.  His employer offered life insurance that he could keep after he stopped working if he could prove he had been disabled when he stopped working.

After his stroke, when our client quit working the first time his employer’s life insurance policy was with Jefferson Pilot.  In the months before our client came back and attempted to work, his employer switched to a life insurance policy with Sun Life.  our client then tried to work a few months but failed.  He applied to keep his life insurance, because he was disabled when he quit working.  Jefferson Pilot denied the coverage saying that he had come back to work after their policy ended, and therefore did not remain “totally disabled.”  Sun Life also denied coverage saying that because he could not fully perform his job when he tried to come back, he was not “actively at work” enough to be covered by their policy.

After we sued, the court ultimately held that because our client did not fully return to work, he was not “gainfully employed” enough to not be “totally disabled.”  Unfortunately, by that time he had passed away, but we were able to obtain the life insurance benefits for his widow though our success in this case.

Ulcerative colitis, frequent diarrhea, bowel disease, Crohn’s disease:

 
Our Client v. Bridgestone/Firestone Long-Term Disability Benefits Plan

No. 4:03-CV-60, 2005 WL 1240603 (E.D.Tenn. March 1, 2005).

Our client, the plaintiff, had to stop working at Bridgestone due to ulcerative colitis and frequent diarrhea, and was awarded benefits under Bridgestone’s self-funded and self-administered LTD plan.  A self-funded and self-administered plan is one in which Bridgestone itself decided which employees were disabled, and paid benefits out of company funds.

During the first two years of benefits, while the plaintiff only had to be disabled from her own occupation, she underwent a total proctocolectomy and ileostomy.  After Bridgestone paid benefits for two years, Bridgestone asked for updated records, and received disabling opinions from the plaintiff’s treating doctors.  A committee at Bridgestone then denied her ongoing benefits based on a verbal report to the committee by a doctor hired by Bridgestone.

We sued Bridgestone on behalf of our client under ERISA, and ultimately the court agreed with us that it was arbitrary and capricious to deny benefits based only on the verbal report of one doctor when all the other doctors supported disability.

Fibromyalgia & Osteoarthritis:

 
Our Client v. BWXT Y-12, LLC

3:04-CV-7, 2005 WL 2097796 (E.D.Tenn. August 29, 2005).

Our client, an accounting support specialist at Lockheed Martin, became disabled due to the chronic pain and fatigue caused by fibromyalgia and osteoarthris. Once she had been disabled for two years, she had to prove she was disabled from any occupation.  At that point, MetLife, the insurance company for her employer, denied the claim based on the opinion of a doctor who only reviewed our client’s medical records.  The court agreed with our arguments and found MetLife was arbitrary and capricious for ignoring the opinions of doctors who actually examined and treated her, and also for ignoring the finding by the Social Security Administration that she was totally disabled.

Avascular necrosis (AVN), hip replacement:

 
Our Client v. Aetna Life Insurance Company

375 F. Supp. 2d 663 (E.D. Tenn. 2005).

Our client, the plaintiff, was disabled due to avascular necrosis (AVN) in his hips, but his claim was denied by Aetna.  Aetna claimed that our client’s AVN was related to a different medical condition that was preexisting, and not covered under the policy, and therefore the AVN was not covered because it was “related to the preexisting condition.”  Later the plaintiff had a hip replacement because of the AVN, and Aetna continued to claim it was related to a preexisting condition, but even if it were not, it would not be totally disabling.

Aetna attempted to rely on one or two of its own doctors, while ignoring even other doctors Aetna had hired, as well as treating doctors.  The court ultimately agreed with us that the plaintiff was entitled to benefits.

Depression and Anxiety:

 
Our Client v. Metropolitan Life Insurance Company

No. 1:06-CV-165, 2007 WL 2746886 (E.D. Tenn. Sept. 19, 2007).

Our client became disabled from depression and anxiety while working at USEC’s Paducah Gaseous Diffusion Plant as a health physics technician.  Throughout the administrative appeals process, MetLife, USEC’s claims administrator, denied our client’s claim for long-term disability benefits on the basis that her medical records did not contain specific medical tests that evidenced her depression and anxiety.  However, the court held that MetLife had acted arbitrarily and capriciously by incorrectly placing the burden on our client to prove her disability of mental illness when the plan required MetLife to ask our client for whatever information (such as specific medical tests) they needed.

Court-awarded attorney’s fees:

 
Our Client v. Metropolitan Life Insurance Company

Report and Recommendation, No. 1:06-CV-165, 2008 U.S. Dist. LEXIS 112854 (E.D. Tenn. July 7, 2008) and Order adopting R & R, No. 1:06-CV-165, 2008 WL 2952473 (E.D. Tenn. July 29, 2008)

After arguing the substantive issues of this case in the United States District Court for the Eastern District of Tennessee, the District Court remanded this case to MetLife for a proper decision.  The District Court then granted our motion for attorney’s fees in the amount of $16,933.00, including $350 for reimbursement of the client’s court-filing fee.

Denial over tuned, benefits awarded:

 
Our Client v. Metropolitan Life Insurance Company

No. 1:06-CV-165, 2011 WL 1103429 (E.D. Tenn. Feb. 19, 2011) (Not reported in F. Supp. 2d)

This is a Report and Recommendation by the Magistrate Judge, recommending a favorable decision for our client.  The district court judge over the case accepted this Report and Recommendation, and entered a final order approving benefits for our client, which is reported at *redacted* v. Metro. Life Ins. Co., 803 F. Supp. 2d 803 (E.D. Tenn. 2011).

This case was our client’s second time in court on her claim.  In her first case, the court found the insurance company to have acted arbitrarily and capriciously, but rather than pay benefits the first time, the court remanded back to the insurance company.  After the insurance company again denied her claim, we brought the case back to court and finally won our cient the benefits she was entitled to.

In this second case, the court explained again, but in more detail, the history of our client’s case, She became disabled and had to stop working at U.S. Enrichment Corporation’s (USEC) Paducah Gaseous Diffusion Plant as a Health Physics Technician in October 2001 due to major depression and anxiety.  The court noted the plant was the only place in the United States that enriched uranium, and the Paducah Gaseous Diffusion Plant was one of the top five targets in the September 11, 2001 terrorist attacks.

Our client had received long-term disability benefits from MetLife because of her disability that began in October 2001, but eventually MetLife arbitrarily and capriciously terminated her benefits based on a supposed lack of information.  MetLife had ignored the extensive information showing she had been diagnosed with Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder with Agoraphobia, Obsessive-Compulsive Disorder, and Post-Traumatic Stress Disorder.  Ultimately the court agreed with us that it was arbitrary and capricious to deny benefits because MetLife did not conduct an independent medical examination of our client and did not ask for the tests that it said were missing.  Finding that MetLife made the same type of mistakes it had the first time, the court reversed MetLife’s termination of her long-term disability benefits and awarded our client her benefits.

Insurance company is wrong to rely on file-reviewing doctors who ignored evidence, and to fail to have claimant examined when court suggested it. Evaluation of disability caused by mental health issues:

 
Our Client v. Metropolitan Life Insurance Company

803 F. Supp. 2d 803 (E.D. Tenn. 2011)

This is the last order in this long case in which MetLife refused to pay benefits, continuing to rely on doctors who only reviewed the file, and did not do a good job of doing that. The district court in Tennessee first remanded the case, No. 1:06-CV-165, 2007 WL 2746886 (E.D. Tenn. Sept. 19, 2007) (summarized above) making MetLife re-do its decision, because when they denied her case the first time, MetLife had denied her before giving her a chance to submit the evidence MetLife later said they wanted, and then MetLife arbitrarily relied on a file-reviewing doctor over the doctors who actually treated our client.When MetLife had a second chance to get it right MetLife denied the claim again. We took the case back to court, and the Magistrate Judge issued a new Report and Recommendation finding MetLife’s decision to deny was so bad that it should be overturned and MetLife should have to pay our client benefits. No. 1:06-CV-165, 2011 WL 1103429 (E.D. Tenn. Feb. 19, 2011) (summarized above).MetLife appealed the Magistrate Judge’s order, still trying to deny our client’s benefits, but the District Court Judge over the case issued this order, confirming that MetLife should have paid the benefits. The court again explained that MetLife’s decision to ignore our client’s treating doctor, to rely only on a file-reviewing doctor, and MetLife’s choice not to have our client examined in person, was a “compelling factor” in deciding MetLife was arbitrary and capricious. MetLife also was wrong to rely on the file-reviewing doctors who picked and chose just parts of the records they reviewed to say our client was not disabled, while MetLife’s doctors ignored other parts of the records that showed how our client was still disabled.

Denial overturned and remanded.  Insurance company was arbitrary and capricious:

 
Our Client v. Liberty Life Assurance Company

132 Fed. Appx. 253 (11th Cir. 2005) (Unpublished).

Our client had to stop working as a senior claims underwriter at AFLAC due to mixed connective tissue disorder, fibromyalgia, Reynaud’s phenomenon, and collagen vascular disorder; she took medical leave from her job, and AFLAC terminated her when her medical leave was completed.  Before she was terminated, however, she applied for long-term disability benefits under a policy administered by Liberty.  After reviewing her medical files, Liberty denied her claim.

We sued Liberty on behalf of our client under ERISA, and the court of appeals ultimately agreed with us that it was arbitrary and capricious to deny benefits based on an incomplete and cursory initial claims investigation, reversing the grant of summary judgment in favor of Liberty and remanding the case to Liberty to make a proper decision.

ERISA, back pain, ERISA appeal deadlines, ERISA regulations:

 
Our Client v. Metropolitan Life Insurance Company

3:06-1099, 2009 WL 603003 (M.D. Tenn. Mar. 9, 2009).

Our client, the plaintiff, worked as a sales representative for Georgia-Pacific until October 2002 when he had to stop working because of chronic lower back pain.  He applied for and was awarded long-term disability benefits starting March 8, 2003.  Two years later, MetLife wrote the plaintiff to let him know his benefits were being terminated.  The letter from MetLife gave the plaintiff 60 days to respond in writing and request a review of his claim denial.  The plaintiff wrote MetLife in May 2003 and was told the denial of his claim was final.

The plaintiff hired us in December 2005, and we helped him obtain updated medical information, and tried to get MetLife to consider that information.  After MetLife refused to consider the new information, we sued MetLife under ERISA, and the court agreed with us that when MetLife instructed the plaintiff that an appeal of his benefits termination was to be filed within 60 days, rather than 180 days, as required by ERISA, MetLife committed “a serious procedural error.”  The court then remanded the case to MetLife for a full and fair review of the plaintiff’s claim.

ERISA discovery, Unum, Provident, ERISA conflict of interest:

 
Our Client v. Provident Life & Accident Insurance Company

271 F.R.D. 584 (E.D. Tenn. 2011).

Before going into the facts of this case, it is necessary to point out that what follows is not a decision or opinion on the whole case.  Rather, it is regarding a discovery order along the way.  This is important because courts do not always allow discovery in ERISA cases.  When we argue for discovery and are successful, it is worth noting.

On behalf of our client, we asked the court to require Provident, the insurance company to provide us information about their bias in claims handling, which would affect the court’s standard of review.  Under ERISA, insurance companies often get the benefit of the doubt, but evidence of bias in their decision-making can mean they get less deference in court.

We argued, and the court agreed with us, that normally a party cannot get discovery to add to the merits of an ERISA case, but can get new information about an insurance company’s biased and unfair claims handling.  So, for example, the court agreed that our request for monthly trends reports from the insurance company should be granted because the reports showed the company’s bias against granting disability benefits claims.

ERISA, Lincoln National, fibromyalgia:

 
Our Client v. Lincoln National Life Insurance Company

No. 3:11-00021, 2012 WL 1902396 (M.D. Tenn. May 25, 2012).

Our client, a senior payroll specialist at Alive Hospice, became disabled due to the chronic pain and fatigue caused by fibromyalgia, and she applied for long-term disability benefits under a plan offered by her employer and administered by Lincoln National.  To qualify under the plan for long-term disability benefits, our client had to be totally disabled, as defined by the plan.

Lincoln National denied our client’s disability benefits twice, and then we sued the insurance company under ERISA.  Lincoln National argued that our client’s medical records did not contain objective evidence of total disability, and, therefore, our client was not totally disabled and could do her job.

We argued, and the court agreed with us, that our client’s pain was the central basis for her disability and that her fibromyalgia was the key consideration in the determination of her total disability.  Fibromyalgia, a condition that cannot be documented by medical tests, made Lincoln National’s reliance on the lack of objective medical evidence arbitrary and capricious.

ERISA regulations, ERISA appeal deadlines, Unum, Provident, ERISA conflict of interest:

 
Our Client v. Provident Life & Accident Insurance Company

No. 3:12-CV-01226, 2014 WL 1280278 (M.D. Tenn. Mar. 27, 2014).

The plaintiff in this case, our client, stopped working as a production assistant for Nissan due to lower back pain and took disability leave on December 15, 1999.  On June 16, 2000, our client submitted a claim for long-term disability benefits under a group policy administered by Unum.  On July 23, 2000, Unum approved our client’s claim and paid him long-term disability benefits until 2012.

In an April 11, 2012 letter, Unum notified our client that it was terminating his long-term disability benefits and gave him 90 days to appeal the denial of benefits.  Our client hired a different attorney before us, who did not file an appeal within the 90 days.  After the 90 days was up, our client hired us, and we appealed on his behalf within 180 days, and we argued to Unum that they should have allowed him 180 to appeal.

Unum refused to consider the appeal we sent in, claiming that they could require him to appeal under a shorter 90-day deadline, because his claim was controlled by an old version of his policy and older ERISA regulations.

We argued that Unum could not use that shorter deadline, because the policy, or plan, under which our client was covered, had been amended while he was being paid benefits.  The new version of the plan allowed for a full 180 days to appeal, as was required by more recent ERISA regulations.  The court ruled in our client’s favor that his appeal was filed on time and that Unum was arbitrary and capricious to require him to appeal in the shorter time.  Rather than addressing whether he was disabled or not, the court remanded the case back to Unum to require them to finish their decision-making process.

ERISA, MetLife, limitations on coverage for certain medical conditions, objective testing for back and musculoskeletal conditions:

 
Our Client v. Metropolitan Life Insurance Company

574 F. Supp. 2d 838 (M.D. Tenn. 2008).

Our client suffered from severe back, neck, and shoulder pain.  After receiving benefits for two years, Met Life cut off our client’s benefits claiming that his condition was subject to an exception which limited his benefits to two years.  We helped our client appeal this denial.  The court found that our client’s condition did not fall into the two-year exception and reinstated our client’s benefits.  The court also found that MetLife acted arbitrarily by having the consulting doctor only review our client’s file and by not having our client undergo the tests suggested by both the consulting doctor and our client’s treating doctors.  Finally, the court awarded pre-judgment interest on our client’s lost benefits and attorney’s fees to discourage MetLife from not fulling reviewing other claims.
 
Our Client v. Nortel Networks Short-Term & Long-Term Disability Plan

594 F. Supp. 2d 870 (M.D. Tenn. 2009).

This ERISA case came to trial because the insurance company cherry-picked which medical information to give weight in determining the Plaintiff’s long-term disability status.  Specifically, the insurance company totally ignored the treating doctor.  Also, the insurance company improperly ignored the Plaintiff’s complaints of pain and did not examine him.  We sued the insurance company on behalf of our client under ERISA because his long-term disability benefits were denied.  The court agreed that the insurance company was wrong, arbitrary, and capricious and reversed the termination of the Plaintiff’s long-term disability benefits and remanded the case to Prudential for a proper decision.

After a year and a half of increasing back pain, our client had to stop working as a systems design engineer for Nortel Networks, Inc.  He received short-term disability benefits and some long-term disability benefits before Prudential denied his long-term disability benefits on May 18, 2005.  Prudential gave credit to the April 2004 opinion of one of our client’s treating physicians, Dr. Gracer, and awarded long-term disability benefits starting May 18, 2004.  Yet, one year later, Prudential did not consider all of Dr. Gracer’s February 2005 “Work Status Form.” Prudential focused only on the portions of the “Work Status Form” that were helpful to the Plan.

Prudential improperly ignored the Plaintiff’s complaints of pain, without an examination.  Prudential simply relied on its paid medical file consultation with its in-house doctor, Dr. Syrjamaki, to discredit Plaintiff’s complaints of pain, ignore Dr. Gracer’s limitations and restrictions, and uphold its decision to deny long-term benefits.

ERISA discovery, ERISA conflict of interest, courts should take into account the bias when insurance companies use doctors who will favor the insurance company:

 
Our Client v. Metropolitan Life Insurance Company

No. 3:05-CV-240, 2006 WL 1006578, (2006) (unpublished)

We were successful in our arguments that we should be allowed to obtain information about how often MetLife used the same doctors over and over to provide opinions to help MetLife deny claims.  We also sought information about how much MetLife paid those doctors (or the company that hired the doctors).

The court allowed us to ask these questions, called “discovery,” which was significant, because this was an ERISA case, and such discovery is not always permitted. Usually, discovery in ERISA cases is limited to the administrative record.  However, here, the court recognized a limited exception involving certain challenges, such as bias, conflict of interest, or denial of due process.

Dr. Porter reviewed her medical file for MetLife.  The discovery questions sought information regarding the relationship between MetLife and the doctor, as well as the money he was paid.

The court allowed the discovery because we showed the court that MetLife had a habit of using the same doctors over and over again, and those doctors were paid well.  One of the doctors who reviewed our client’s file for MetLife, Dr. Porter, the president and CEO of Network Medical Review Company (“NMR”), contracted with MetLife for over $500,000 for reviewing 850 medical files.  In addition, we drew the court’s attention to the fact that the Seventh Circuit noted that MetLife used NMR extensively.  The court agreed with us and compelled Dr. Porter to answer discovery questions.

Fibromyalgia, objective evidence, cherry-picking, duty to have claimant examined, obligation to consider all conditions, obligation to consider side effect of medications:

 
Our Client v. Metropolitan Life Insurance Company

No. 3:05-CV-240, 2007  WL 956640 (2007) (unreported)

We helped our client win ERISA long term disability (“LTD”) benefits because the court agreed with our arguments that MetLife improperly denied our client’s benefits.  The court agreed that MetLife relied only on the evidence that supported its decisions to deny long term disability to our client and ignored other documents that supported our client’s claim.

Our client claimed disability due to fibromyalgia, chronic pain, and other conditions, including mental health issues.  MetLife denied our client, saying there was not enough “objective evidence” of disability, relying only on doctors they hired to review medical records.

The court agreed with our arguments that MetLife was not only wrong, but was arbitrary and capricious for relying only on doctors it hired, who did not examine the claimant, yet they decided her pain and limitations were not believable.  MetLife was also arbitrary and capricious for failing to take into account the opinions of the doctors who actually examined and treated the claimant, for failing to take into account the effects of her medications, and for failing to consider all her medical conditions.

 

Under Construction –  Because we make it a priority to work on our current clients’ cases, we have not had time yet to finish all the summaries of our past cases.  We apologize for the work in progress.

 

Our Client v. Metropolitan Life Insurance
No. 3:06-1099, 2010 WL 1609494 (M.D. Tenn. Apr. 20, 2010).
(Details to be added soon!)
Our Client v. Metropolitan Life Insurance Company
No. 1:07-CV-222, 2010 WL 1252817, (E.D. Tenn. March 24, 2010).
(Details to be added soon!)
Our Client v. Metropolitan Life Insurance Company
1:07-CV-222, 2009 WL 6313560 (E.D.Tenn. June 1, 2009).
(Details to be added soon!)
Our Client v. Lincoln National Life Insurance Company
660 F. Supp. 2d 830 (M.D. Tenn. 2009).
(Details to be added soon!)
Our Client v. Greater Georgia Life Insurance Company
649 F. Supp. 2d 802 (E.D. Tenn. 2009).
(Details to be added soon!)
Our Client v. Long Term Disability Insurance for Employees of Schwan’s Shared Services
No. 1:08-CV-256, 2009 WL 1362045 (E.D. Tenn. May 13, 2009).
(Details to be added soon!)
Our Client v. Unum Life Insurance Company of America
593 F. Supp. 2d 1303 (N.D. Ga. 2008).
(Details to be added soon!)
Our Client v. Reliance Standard Life Insurance Company
654 F. Supp. 2d 731 (E.D. Tenn. 2009).
(Details to be added soon!)
Our Client v. Reliance Standard Life Insurance Company
No. 1:06-CV-267, 2007 WL 2897870 (E.D. Tenn. September 28, 2007).
(Details to be added soon!)
Our Client v. Reliance Standard Life Insurance Company
428 Fed. Appx. 537 (6th Cir. 2011) (Unpublished).
(Details to be added soon!)
Our Client v. Secretary of Health and Human Services
854 F.2d 815 (6th Cir. 1988).
(Details to be added soon!)
Our Client v. Metropolitan Life Insurance Company
514 F.Supp.2d 1024 (E.D.Tenn. 2007).
(Details to be added soon!)
Our Client v. Life Insurance Company of North America
No. 3:05-CV-296 , 2007 WL 128326 (E.D.Tenn. Jan. 11, 2007).
(Details to be added soon!)
Our Client v. Walgreen Income Protection Plan for Store Managers
455 F.Supp.2d 734 (M.D. Tenn. 2006).
(Details to be added soon!)
Our Client v. Walgreen Income Protection Plan For Store Managers
No. 3:05-0162, 2006 WL 3694580 (M.D.Tenn. Dec. 14, 2006).
(Details to be added soon!)
Our Client v. Baker Hughes Inc. Long Term Disability Plan
No. 2:05-CV-63, 2006 WL 270283 (E.D.Tenn. February 2, 2006).
(Details to be added soon!)
Our Client v. Provident Life & Accident Insurance Company
No. 3:04-CV-0113, 2006 WL 208878; 37 Employee Benefits Cas. (BNA) 2364, (M.D.Tenn. Jan. 25, 2006).
(Details to be added soon!)
Our Client v. Unumprovident Corporation
Nos. 1:04-CV-162,1:04-CV-163, 2005 WL 6731769 (E.D.Tenn. Oct. 21, 2005).
(Details to be added soon!)
Our Client v. Prudential Insurance Company of America
383 F. Supp. 2d 980 (M.D. Tenn. 2005).
(Details to be added soon!)
Our Client v. Prudential Insurance Company of America
581 F. Supp. 2d 904 (E.D. Tenn. 2008).
(Details to be added soon!)
Our Client v. Unum Life Insurance Company of America
321 F. Supp. 2d 925 (E.D. Tenn. 2004).
(Details to be added soon!)
Our Client v. Hartford Life & Accident Insurance
No. 1:03-CV-172, 2003 WL 23413737 (E.D.Tenn. December 12, 2003).
(Details to be added soon!)
Our Client v. Intertrade Holdings, Inc.
No. 1:02-CV-173, 2003 WL 21938912; 31 Employee Benefits Cas. (BNA) 1984, (E.D.Tenn. July 7, 2003).
(Details to be added soon!)
Our Client v. Metro. Life Insurance Company
No. 3:15-CV-01186, 2017 WL 660680 (M.D. Tenn. Feb. 17, 2017).
(Details to be added soon!)
Our Client v. Metro. Life Insurance Company
No. 3:15-CV-01186, 2016 WL 7325334 (M.D. Tenn. December 15, 2016).
(Details to be added soon!)
Our Client v. United States Life Insurance Company of America
185 F.Supp.3d 1010 (S.D. Ohio 2016).
(Details to be added soon!)
Our Client v. Unum Life Insurance Company of America
181 F.Supp.3d 465 (E.D. Tenn. 2016).
(Details to be added soon!)
Our Client v. United of Omaha Life Insurance Company
No. 1:14-CV-72, 2015 WL 5562196 (E.D. Tenn. September 21, 2015).
(Details to be added soon!)
Our Client v. United of Omaha Life Insurance Company
No. 1:14-CV-72, 2015 WL 5562193 (E.D. Tenn. June 1, 2015).
(Details to be added soon!)
Our Client v. Liberty Life Assurance Company of Boston
647, Fed. Appx. 539 (6th Cir. 2016).
(Details to be added soon!)
Our Client v. Liberty Life Assurance Company of Boston
No. 14-22-DLB-HAI, 2015 WL 4529297 (E.D. Ky. July 27, 2015).
(Details to be added soon!)
Our Client v. Merck & Co., Inc.
No. 3:13-CV-01085, 2015 WL 1311737 (M.D.Tenn. March 23, 2015).
(Details to be added soon!)
Our Client v. Aetna Life Insurance Company
No. 2:13-CV-310, 2015 WL 1299515 (S.D. Ohio, March 23, 2015).
(Details to be added soon!)
Our Client v. Life Insurance Company of North America
No. 1:13-CV-339, 2015 WL 1243529 (E.D. Tenn. March 18, 2015).
(Details to be added soon!)
Our Client v. United of Omaha Life Insurance Company
No. 13-CV-02996 SHL, 2014 WL 5822846 (W.D. Tenn. November 10, 2014).
(Details to be added soon!)
Our Client v. Aetna Life Insurance Company
32 F.Supp.3d 894 (W.D. Tenn. 2014).
(Details to be added soon!)
Our Client v. Aetna Life Insurance Company
33 F.Supp.3d 782 (E.D. Ky. 2014).
(Details to be added soon!)
Our Client v. Federal Express Corporation
62 F.Supp.3d 681 (W.D. Tenn. 2014).
(Details to be added soon!)
Our Client v. Provident Life and Accident Insurance Company
No. 3:12-CV-01226, 2014 WL 1280278 (M.D. Tenn. March 27, 2014).
(Details to be added soon!)
Our Client v. Provident Life and Accident Insurance Company
No. 3:12-CV-01226, 2014 WL 460018 (M.D. Tenn. February 05, 2014).
(Details to be added soon!)

Our Client v. Eaton Corporation Disability Plan
740 F.3d 1059 (6th Cir. 2014).
(Details to be added soon!)
Our Client v. Bayer Corporation Long Term Disability Plan
No. 3:04-CV-128, 2009 WL 676774 (E.D. Tenn. Mar. 11, 2009).
(Details to be added soon!)