In Thomas v. Prudential Insurance Co. of America, et al., plaintiff Thomas learned the hard way the importance of filing an ERISA lawsuit within the time frames established by the employer-sponsored disability benefits plan. Without even referencing the medical condition upon which Thomas based her claim for long-term disability benefits, a federal district court in Louisiana dismissed her lawsuit due to her failure to file it on time.
Disability Plan Time Limits Required Dismissal of the Complaint
1. The ERISA complaint was required to be filed within an established period of time.
The Plan applicable to Thomas’s case specifically required legal action to commence within three years of the time that proof of the claim was required, which was within 90 days of the 180-day elimination period. According to her complaint, Thomas’s disability began “on or about” June 26, 2009. This meant she should have filed her lawsuit by March 23, 2013, but she did not file it until December 1, 2014, twenty months after the time for filing had expired. The court concluded that even if it gave her “some measure of approximation” as to the starting date of her disability, the long delay in filing the complaint was still far outside the time limits established by the Plan and her complaint should be dismissed.
2. The Plan provision for a possible one-year extension did not create ambiguity in the time limitations of the plan and, in any case, the clause did not apply to Thomas’s case.
The Plan had a provision for claimants unable to provide proof of their claim within 90 days after the elimination period to have an extension of one year in which to file their federal ERISA lawsuit. Thomas argued that this caused the limitations period to be ambiguous and thus she should be allowed to pursue her claim.
The court disagreed and held that the clause was not ambiguous. Furthermore, Thomas did not even claim that the one-year extension applied to her. But, even if it did, her claim was not filed within that period of time and should still be dismissed.
3. Language in the Summary Plan Description (SPD) is not enforceable.
In her reply to the defendant’s opposition, Thomas argued that there was language in the SPD that should prevent dismissal of her claim as untimely. The court, relying on U.S. Supreme Court precedent, held that the SPD is not part of the plan and not enforceable. Even so, there was no language in the particular SPD that would save Thomas’s lawsuit from dismissal as untimely.
Since Thomas’s ERISA complaint for disability benefits was not filed with the time frame established by the Plan, it was dismissed with prejudice.
If you have questions regarding your claim for disability benefits, call Disability Attorneys Dell & Schaefer as soon as possible for a free consultation. Do not lose forever your ability to pursue your claim by letting the time for filing your ERISA lawsuit to expire.