A Virginia disability lawyer recently filed a federal lawsuit against The Guardian Life Insurance Company Of America (Guardian). The Plaintiff, Randal M., worked as a Master HVAC Installer for Parrish Services in Manassas, Virginia since October 15, 2008. Due to this employment, he was eligible for and enrolled in an employee welfare benefit plan that provided long-term disability benefits. These benefits were sponsored by Parrish Services and were underwritten and administered by Guardian.
In Randal M. Vs The Guardian Life Insurance Company Of America, Plaintiff filed a disability lawsuit to recover the long-term disability benefits wrongfully denied by Guardian.
Case Facts Against Guardian
Plaintiff worked as a Master HVAC Installer for Parrish Services in Manassas, Virginia since October 15, 2008. Plaintiff also had certifications to work as a gasfitter, plumber, HVAC, and electrician for Parrish Services.
In August 2009, Plaintiff was first diagnosed with an injury or illness to his spine at Lumbar 3 (L-3) and Lumbar 4 (L-4), which eventually led to his being totally disabled. Plaintiff applied for and received short-term disability benefits from Guardian. Plaintiff then applied for long-term disability benefits after the short-term disability benefit payments had run out.
Denial of Long-Term Disability Benefits By Guardian
In April 2010, Guardian denied Plaintiff long-term disability benefits due to the stated reason that the Plaintiff’s condition was pre-existing, making him ineligible for long-term disability benefits as defined by the Plan.
Plaintiff applied for Social Security Benefits and received them beginning on June 1, 2010. Due to the fact that Guardian’s Long-Term Disability benefit is a greater amount than Plaintiff’s Social Security Disability benefit, Guardian is required to supplement the Social Security Benefit amount.
Plaintiff became totally disabled at age 51. Guardian’s Long-Term Disability benefit is to provide LTD benefits to the Plaintiff up to the age of 65. Plaintiff was never diagnosed or treated for an injury or illness to L-3 and/or L-4 before August 2009, thereby negating Guardian’s stated reason of a pre-existing injury or illness making Plaintiff ineligible for LTD benefits as defined by the Plan.
Plaintiff has exhausted his administrative remedies, thereby leading to the filing of this lawsuit against Guardian.
Disability Attorney Files Disability Lawsuit Against Guardian
In the lawsuit, Plaintiff claims that Guardian failed to provide the following to the Plaintiff:
- Guardian did not follow the terms of the Plan in determining that Plaintiff was ineligible to receive long-term disability benefits
- Guardian did not arrive at the proper conclusion that the Plaintiff was eligible for long-term disability benefits because it claimed that the Plaintiff had a preexisting injury or illness in his spine, which was shown to not be the case during the look-back period as defined in the terms of the Plan
- Guardian did not provide long-term disability benefits as were promised under the terms of the Plan
Plaintiff claims that Guardian committed the following wrongful actions against the Plaintiff:
- Guardian committed an abuse of discretion of determining that Plaintiff was ineligible for LTD benefits based on a conflict of interest as both decision-maker and payer of benefits under the Plan
- Guardian caused Plaintiff damages currently unknown to the Plaintiff, but will be approximate to the amount of benefits due to the Plaintiff since April 2010
- Guardian will continue to cause damage to the Plaintiff each month until Plaintiff reaches 65 years of age due to the wrongful denial of LTD benefits, an approximate value of $1,335.00 per month
Relief Sought By Plaintiff In Guardian Lawsuit
Due to the wrongful actions of Guardian, Plaintiff seeks the following relief:
- Guardian pays all long-term disability benefits to the Plaintiff from April 2010 to the present date, along with all accrued interest at the greater interest rate of the prime rate or the rate earned by Guardian on the unpaid policy benefits since April 2010
- Guardian pays all future long-term disability benefits to the Plaintiff so long as he remains eligible under the terms of the Plan
- Guardian pays all of Plaintiff’s attorney fees and cost of experts
- Guardian pays all associated court costs
- Guardian pays punitive damages according to the proof that is presented in the case
- Guardian pays all other relief that is deemed proper and just by the Court
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.