Filing a lawsuit under the Employee Retirement Income Security Act (ERISA) against Prudential Insurance Company of America and KeyCorp Group Insurance Plan in Ohio Federal Court, Tom Morgan and his Ohio disability attorney are seeking to have Prudential award Morgan his rightfully owed disability benefits. Having exhausted all administrative appeals available, Morgan and his disability attorney have no other recourse but to seek a verdict in Court.
An employee at KeyCorp, Morgan was a vested participant in the company’s group long term disability plan and "meets the criteria for payment of benefits under said Plan." Morgan was hired at KeyCorp in March of 2008, was issued a Prudential plan that included disability benefits and promised in the event of disability, he would be entitled to monthly disability benefits should he need it. On March 24, 2010, Morgan ceased working at KeyCorp as the result of a "combination of medical problems." Morgan properly applied for his disability benefits under the insurer’s plan and met the criteria for receiving his disability payments, but was denied those benefits upon initial application and all administrative appeals that followed.
Morgan and His Disability Attorney Accuse Prudential and KeyCorp of Being Unreasonable
Alleging that Prudential and his KeyCorp Group Plan has unjustifiably denied Morgan benefits, Morgan and his disability attorney filed their ERISA lawsuit on June 21, 2011. According to the complaint, Morgan and his disability attorney claim that Prudential owes Morgan long-term disability payments from September, 22, 2010 to the present and continuing. They allege that Prudential’s denial of Morgan’s long term disability application was unreasonable as well as "arbitrary and capricious" because the insurer filled the dual role of evaluator and payor of benefits. Therefore, the decision to deny Morgan his long term disability benefits contains an inherent conflict of interest.
Morgan and his disability attorney believe that Morgan’s medical records conclusively reflect that Morgan "is not capable of performing his own occupation or any other occupation due to his documented medical impairments and that he meets the definition of disability under the policy in question." The complaint states that Prudential and KeyCorp acted "arbitrarily and capriciously" when it refused Morgan’s offer to be subject to a multi-day Function Capacity Evaluation (FCE)to prove his disabled condition. The complaint goes on to allege that Prudential "improperly denied [Morgan’s] application for benefits in violation of the appropriate standard under ERISA statutes.
Relief that Morgan and His Disability Attorney Seek
Consequently, due to the insurer’s violation of ERISA standards, Morgan and his attorney ask the Court to:
- Provide Morgan accrued and ongoing disability insurance payments per the policy, with the inclusion of cost of living adjustments;
- Award Morgan attorney’s fees and cost;
- Award Morgan interest on his benefits;
- Award Morgan statutory damages; and
- Provide Morgan with "other legal and/or equitable relief to which [he] may be deemed entitled.
About the author: Gregory Michael Dell is an attorney and managing partner of the disability income division of Attorneys Dell & Schaefer. Mr. Dell and his team of lawyers have assisted thousands of long-term disability claimants with their claims against every major disability insurance company. To request a free legal consultation call 800-411-9085.