In the case of Simon v. USAA Life Insurance Co., the insurer denied death benefits under a term life policy that had lapsed due to non-payment of the premium two days before the insured’s death. The Eleventh Circuit Court of Appeals affirmed the district court’s decision in favor of the insurer. The policy included a 31-day grace period and allowed for reinstatement after lapse due to non-payment of premium upon receipt of the unpaid premium along with satisfactory evidence that the insured was still insurable. The Eleventh Circuit agreed that the insurer’s retention of the late premium payment for approximately 45 days did not suggest unreasonable delay or that the policy was still in force.

In Harmon v. Unum Life Insurance Company of America, the Sixth Circuit Court of Appeals affirmed the decision supporting a plan administrator’s termination of long-term disability benefits. The plaintiff had been unable to perform any gainful occupation after a back injury. After a clinical consultant and in-house physician reviewed his medical records, they determined he was capable of light work. Consequently, his benefits were terminated.

In McClendon v. United of Omaha Life Insurance Co., the Eastern District of Arkansas sided with the claims administrator, denying the plaintiff’s claim for long-term disability benefits for long-COVID. The plaintiff’s reports of brain fog were consistent, but his extensive test results largely came back normal, without any objective basis for a disabling condition. Thus, the court agreed with the administrator’s conclusion that the plaintiff did not provide enough information to determine the extent of any disability.

Navigating insurance claims and benefits can be a complex process. If you need help understanding your rights and options, it may be beneficial to speak with a professional. For those facing unemployment issues, eddcaller.com is a helpful resource. Through this site, you can learn about how to reach an agent at EDD. They provide valuable information on California unemployment customer service, how to contact a live person at EDD in California, and other key contact details to help you navigate the unemployment process smoothly.