A federal lawsuit was recently filed by a Florida disability attorney against the Berkshire Life to recover monthly disability benefit payments wrongly withheld. As a Senior Strategic Accounts Manager for Walgreen’s, Inc., George F., was covered by Berkshire’s monthly disability benefit plan.

The Facts of the Case Against Berkshire Life Insurance Company Of North America

The plaintiff, George F., suffers from multiple medical conditions and symptoms, including herniated disk, radiculitis, spondylosis, spinal stenosis, intractable radiculopathy, and L5-S1 retrolisthesis. Plaintiff has undergone diskectomy, foraminotomy, and L5-S1 facetectomy due to these conditions and symptoms.

Due to these conditions, Plaintiff attempted to work in a reduced capacity from July 27, 2009 to September 30, 2009, but ceased working on September 30, 2009 due to being unable to work in a reduced capacity.

In accordance with the procedures set forth in the Plan and fitting the terms of the “Total Disability” provision in the Plan, Plaintiff filed an Individual Disability Claims Notice of Claim Form to Berkshire on January 20, 2011.

Delay of Berkshire Disability Benefits Claim

Berkshire has not yet made a determination in regards to Plaintiff’s disability claim. According to the Plan, Plaintiff may bring legal action against Berkshire within 60 days after a submittal of proof of loss, as Plaintiff has done.

Plaintiff also added an Attending Physician Statement in his submittal to Berkshire on May 24, 2011. An Orthopedic Surgeon informed Berkshire that he was restricting Plaintiff’s workload, including not lifting objects that weighed more than five to eight pounds. The doctor also stated that Plaintiff was a likely candidate for additional surgery in the future to correct his spinal ailments. All of this further aids the claim that Plaintiff meets the definition of “Total Disability” as defined in the Plan.

Berkshire’s failure to reach a decision in a timely and reasonable manner regarding the Plaintiff’s claim violates the terms of the Plan and Florida law. As a result, Plaintiff has retained an attorney and has filed this lawsuit.

Florida Disability Lawyer Files Lawsuit Against Berkshire

According to the lawsuit, Berkshire is alleged to have failed to provide the following to the plaintiff:

  • Monthly disability payments as defined by the Plan, along with interest, through age 65
  • Honor its obligations as defined by the Plan
  • Comply with the terms of the Plan

Relief Sought By The Plaintiff In The Berkshire Lawsuit

Due to Berkshire’s actions, Plaintiff wants the following relief from the Court:

  • A jury trial on all issues that are deemed to be triable
  • All contractual benefits and pre-judgment interest
  • All premiums since the date of Plaintiff’s disability
  • All court costs
  • All attorney’s fees
  • All further relief that the Court deems to be proper and just

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.