Disability Blog & Cases:
Microsoft Employee Sues Prudential For Wrongful Denial Of Long-Term Disability Benefits

A Washington lawyer just filed a federal lawsuit against The Prudential Insurance Company of America (Prudential). The Plaintiff, Jewel T., worked as an Escalation Specialist for Microsoft. This employment entitled to the Plaintiff to short-term and long-term disability benefits via Microsoft’s Group Disability Insurance Plan that was funded by Prudential.

Disability Blog & Cases:
Toyota Quality Assurance Monitor Sues Life Insurance Company Of North America For Denial Of Long-Term Disability Benefits

A disability attorney in the state of Indiana recently filed a federal lawsuit in Indiana against Life Insurance Company of North America (LINA) and Toyota Motor Long-Term Disability Plan (Toyota). The Plaintiff, Julie S., was employed by Toyota as a Quality Assurance Monitor, which made her eligible for Toyota’s long-term disability plan, which was funded by LINA.

Disability Blog & Cases:
Illinois Insurance Law Gives Claimant A Fighting Chance Against Disability Insurance Company

An Illinois district court refused to let Hartford, a disability insurance company, evade an Illinois law, which was enacted to protect consumers. The law was passed to basically “level the playing field” for insurance companies and the consumers that rarely have a fighting chance against these corporate giants.

Disability Blog & Cases:
Pennsylvania Court Awards STD Benefits And $27,000 In Attorneys’ Fees To Phlebotomist

A Pennsylvania court recently awarded $27,000 in attorneys’ fees to Ms. G. after she and her disability attorney won a judgment against Life Insurance Company of North America (“LINA”) also known as CIGNA for short-term disability (“STD”) benefits. This case is a good discussion of the analysis a court will go through in order to award attorney fees to a prevailing disability insurance claimant.

Long term disability insurance provides the needed safety net to protect against disabling injury or illness. Some insurance companies offer a provision called a "lump sum buyout" which may be beneficial to the policy holder.

A lump sum buyout is the payment of funds in exchange for the surrender of one’s long term disability policy. As a way to save money, insurance carriers calculate these buyouts based on the amount they project they will have to pay a claimant in the future, but at an overall reduced rate.

Each insurance company has their own methodology in determining the buyout amounts, however, there is a general principle that most insurance companies follow: if the lump sum buyout amount is less than the expected monthly payments, insurers will try to negotiate a buyout.

Lump sum buyouts are always at a discounted rate, which seems like it would be in an insurer’s interest to continue to collect benefits instead of a lump sum payment. However, this is often not the case.

Let’s examine the potential benefits of a lump sum buyout below:

  1. Lump sum buyouts provide extra security for a claimant’s family. Long term disability insurance policies contain no rights of survivorship that are commonly present in life insurance policies. To obtain a lump sum buyout, there is additional financial security in case of an emergency.
  2. While receiving long term disability benefits, there’s always a risk that benefits will be denied or cut off. With a lump sum buy out, there is a freedom to live without the constant fear of a denial.
  3. The cash received in the lump sum buyout is often tax-free and free to use and further invest.
  4. A claimant can return to work without hurting a claim or subject to the scrutiny of insurance companies.

It is essential to consult an attorney when planning a lump sum buyout. These are complicated processes which require the expertise of an attorney to negotiate the best possible lump sum settlement.

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.

The Prudential Insurance Company of America (Prudential) was sued in three separate cases in the Federal Courts of Missouri, Georgia, and Arizona for the wrongful termination of long-term disability benefits that are promised under the Employee Retirement Income Security Act (ERISA). In all three cases filed through the respective plaintiffs’ disability lawyers, Prudential is accused of denying the Plaintiffs the short-term or long-term disability benefits that were promised under the Plaintiffs’ respective plans.

The Missouri Case

In Mary J. Vs. The Prudential Insurance Company of America, a long-term disability lawsuit was filed by the Plaintiff against Prudential via a Missouri disability attorney in the Eastern District of Missouri Eastern Division. The Plaintiff had been employed full-time by Harrah’s Operating Company, Inc. (Harrah’s) since 2000, making her eligible for long-term disability benefits through Harrah’s Group Policy No. 42111 Plan. This Plan was insured by Prudential.

The Plaintiff ceased working in October 2007 due to degenerative arthritis of both knees and filed for long-term disability benefits. Prudential approved the claim on February 21, 2008. However, Plaintiff was notified on September 23, 2009 that she would no longer receive long-term disability benefits after February 20, 2010.

Plaintiff appealed the denial on February 9, 2010, but Prudential upheld the denial on August 30, 2010. Due to exhausting all administrative remedies, Plaintiff has filed this lawsuit against Prudential.

The Georgia Case

In Deborah D. Vs. The Prudential Insurance Company of America, Plaintiff was employed as a Program Manager by DRS Technologies, Inc., which provided both short-term and long-term disability benefits via an insurance plan that was insured and paid for by Prudential.

Plaintiff became disabled on or about August 23, 2010, leading to her filing a timely short-term disability claim, along with medical documentation, with Prudential. Prudential initially approved the STD claim and paid Plaintiff through October 24, 2010.

However, beginning October 24, 2010, Prudential terminated Plaintiff’s benefits on the basis that it had not received enough medical information to continue providing STD benefits. Plaintiff appealed this termination, but via letter dated March 7, 2011, Prudential upheld its original denial.

On September 2, 2011, Plaintiff again appealed and provided additional medical and vocational information to support her claim. However, on October 6, 2011, Prudential upheld its previous denials and declared that this decision was its final decision on the Plaintiff’s claim. Plaintiff has exhausted all administrative remedies and has filed this lawsuit against Prudential.

The Arizona Case

In Gerard L. Vs. Prudential Insurance Company of America and Anheuser-Busch Companies, Inc. (Anheuser-Busch), Plaintiff was employed by Anheuser-Busch as a local employee until on or about March 31, 2009 when he became disabled and unable to work as a Senior Manager of Accounting due to serious medical conditions. This employment enabled the Plaintiff to be covered under Anheuser-Busch’s group long-term disability insurance policy, which was funded by Prudential.

Plaintiff filed a disability application for Total and Permanent Disability and Group Life Insurance benefits under the terms of the Plan. Prudential denied his claim via letter dated December 14, 2010. Plaintiff filed an appeal of this decision and submitted additional medical evidence to support his claim. This included an Independent Medical Evaluation performed on January 26, 2010 that stated that Plaintiff would be unable to work for at least the next 12 months. In addition, Plaintiff applied for and received Social Security Disability benefits through the Social Security Administration.

Despite the additional evidence, Prudential upheld its original denial via letter dated March 23, 2011. Plaintiff again filed an appeal and submitted additional medical evidence. Prudential issued a final denial via letter dated August 1, 2011. Plaintiff has exhausted all administrative remedies and has filed this lawsuit against Prudential.

Relief Requested From The Lawsuits

In the three aforementioned cases, the Plaintiffs seek the following relief from Prudential in their lawsuits:

  • Prudential pays all benefits that are owed to the Plaintiffs, along with accrued interest
  • Prudential reinstates the eligibility of Plaintiffs to receive future benefits for as long as they remain eligible to receive such benefits as defined by the terms of their respective Plans
  • Prudential pays all attorneys’ fees
  • Prudential pays all associated court costs
  • Prudential pays all other relief that the Court deems to be fair 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 800-698-9162.

Disability Blog & Cases:
Clopay Corporation Customer Service Representative Sues Prudential For The Wrongful Denial Of Long-Term Disability Benefits

An attorney recently filed a federal lawsuit in the Ohio district court against The Prudential Insurance Company of America (Prudential) and Clopay Corporation Long-Term Disability Coverage (Clopay). The Plaintiff, Kimberly G., was employed as a Customer Service Representative at Clopay Corporation, providing her with short-term with Principal Financial and long-term disability benefits with Prudential.

Disability Blog & Cases:
Asurion Employee Files Lawsuit Against Life Insurance Company Of North America For Wrongful Termination Of Long-Term Disability Benefits

A lawyer from Colorado just filed a federal lawsuit in Federal Court of Colorado against the Life Insurance Company of North America (LINA). The Plaintiff, Carl E., was employed by Asurion. This made the Plaintiff eligible and covered by a group disability insurance plan provided by Asurion and administered and funded by LINA.

Disability Blog & Cases:
Court orders Life Insurance Company of North America to pay claimant long-term disability benefits

After failing to pay a LINA disability policyholder his entitled disability benefits the insurance company was forced by a New York court to follow through with its contractual obligations. Curt, a former employee of BorgWarner Morse TEC Inc. received long-term disability benefits under the group insurance policy issued by LINA. LINA later concluded the BorgWarner employee no longer met the definition of disabled under the policy and terminated his benefits.

An Illinois disability lawyer filed a federal lawsuit in Federal court against Liberty Life Assurance Company of Boston (Liberty) and Allstate Cafeteria Plan (Allstate). The Plaintiff, William B., was employed by Allstate as a Claim Senior Manager. Due to this employment, Plaintiff was eligible to receive short-term and long-term disability benefits under the Allstate STD Program, which was funded by Liberty.

In William B. Vs. Liberty Life Assurance Company Of Boston and Allstate Cafeteria Plan, Plaintiff seeks payment of wrongfully terminated long-term disability benefits by Liberty.

Case Facts Against Liberty and Allstate

Plaintiff worked as a Claim Senior Manager for Allstate until February 17, 2010 when he stopped working due to a combination of several psychiatric impairments. Before he stopped working, Plaintiff filed a claim for short-term disability benefits under the Allstate STD Program, which was approved by Liberty. Plaintiff began receiving STD benefits from February 25, 2010 to July 7, 2010.

Liberty informed Plaintiff via letter on August 4, 2010 that he was also eligible to receive long-term disability benefits as of July 8, 2010. From August 19, 2010 to May 2011, Plaintiff also received LTD benefits from a separate LTD policy he had purchased on his own.

Termination of Long-Term Disability Benefits By Liberty

On May 5, 2011, Plaintiff was notified by Liberty that he would no longer receive LTD benefits after May 12, 2011. This denial was made primarily due to the results of a file review performed by a non-examining physician.

On July 15, 2011, Plaintiff filed an appeal of this denial, supplying additional evidence that he was still participating in an extended treatment plan and that his doctor refused to grant permission to the Plaintiff to return to work based on his current condition. Despite this additional evidence, Liberty denied the Plaintiff’s appeal on September 9, 2011, again basing their decision on the file reviews conducted by non-examining physicians.

Due to the fact that all administrative remedies have been exhausted, Plaintiff has filed this lawsuit against Liberty and Allstate.

Disability Lawyer Files Lawsuit Against Liberty And Allstate

According to the lawsuit, the Plaintiff claims that Liberty committed the following wrongful actions against the Plaintiff:

  • Terminating the Plaintiff’s long-term disability benefits based on file reviews conducted by non-examining physicians
  • Failing to provide a full and fair review of the Plaintiff’s claim
  • Failing to fully consider the Plaintiff’s current medical condition, which is enough evidence for Prudential Insurance Company of America, payer of the Plaintiff’s other LTD policy, to provide LTD benefit payments to the Plaintiff
  • Causing the Plaintiff financial hardship due to the wrongful termination of LTD benefits

The Following Relief Is Sought By The Plaintiff Against Liberty And Allstate

Due to the actions of Liberty and Allstate, Plaintiff requests the following relief to be granted by the Court:

  • To pay all owed long-term disability benefits
  • To pay all prejudgment interest on owed LTD benefits at a rate of 9% per annum
  • To pay all future LTD benefits as long as the Plaintiff remains eligible to receive them according to the terms of the Plan
  • To pay all reasonable attorney’s fees
  • To pay all associated court costs
  • To pay all other relief that the Court deems 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 800-698-9162.

ERISA is a federal law that governs most disability plans offered through employers and was enacted in part to make it more affordable for employers to offer long-term disability coverage and health insurance for employees. Unfortunately, ERISA tends to be an unfair law for disability insurance claimants.

The limitations and obstacles inherent to an ERISA regulated disability policy do not present themselves oftentimes until a claimant is faced with the unfortunate occasion of becoming disabled and unable to work. One such limitation is that an ERISA governed policy requires a claimant to exhaust administrative remedies before filing a lawsuit. This oftentimes only serves to prolong the time a disabled claimant must wait to receive benefits to which he or she is entitled. In the event that a claimant does file a lawsuit, under ERISA, a claimant is not entitled to a jury trial. The decision is therefore up to the judge who is usually limited to a review of the "claim file" under a standard requiring the judge to determine simply if the administrator acted unreasonably even if the judge thinks the claimant is in fact disabled.

Not surprisingly, disability insurers fight to have ERISA be the governing law over disability policy disputes.

In the case of Healy v. Minnesota Life Insurance Company the claimant sought long-term disability ("LTD") benefits from his insurer and filed suit in Missouri. The Defendant insurance company argued that ERISA governed the policy.

While most plans offered through employers are governed by ERISA, such plans may be exempt from ERISA if the disability plan meets all four requirements set forth in the federal Safe Harbor Regulations.

If a court finds that an employer has "contributed" to the plan then it cannot be exempt under Safe Harbor Regulations.

Minnesota Mutual argues a 10% discount of claimants’ premiums was a "contribution" and that the policy is subject to ERISA

Naturally, Minnesota Mutual argued in an effort to convince the court ERISA governed the policy. Ultimately, the court ruled that the plan was not subject to ERISA after finding the policy had not been "established or maintained by an employer"—a requirement under ERISA. However, the court also explained that the policy was not exempt from ERISA based on the federal Safe Harbor Regulations.

This case is important because the Missouri Federal court joined several other courts in finding that a discount of the claimant’s premiums was a "contribution" and therefore the Safe Harbor exclusionary provision does not apply. In other words, the disability policy, although held by the court to fall outside the purview of ERISA regulation, came dangerously close to falling within ERISA simply because the insurance company offered a 10% discount for purchasing the policy through the claimant’s employer.

When an insurance company offers a discount for obtaining a long-term disability policy through your employer it is important to consider the possible effects the discount may have on the policy. A contribution by an employer could put a policy under ERISA regulation thereby subjecting a claimant to various obstacles and limitations.

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.

Disability Blog & Cases:
Employees of Staples & Nortel Networks among Four Plaintiffs To Sue Prudential For Wrongful Denial Of Long-Term Disability Benefits

The Prudential Insurance Company of America (Prudential) had four different lawsuits filed against it by four Plaintiffs in the District Courts of South Carolina (2 cases), New York, and West Virginia. In all four cases filed via the respective Plaintiffs’ disability lawyers, Prudential is accused of wrongfully denying or terminating the Plaintiffs’ claims for long-term disability benefits as promised under their respective plans and by ERISA.

Disability Blog & Cases:
Kirk & Blum/CECO Environmental Employee Files Lawsuit Against Lincoln Financial Group For Wrongful Termination Of Long-Term Disability Benefits

An attorney has filed a Federal disability lawsuit in Ohio Federal Court against Lincoln Financial Group (Lincoln). The Plaintiff, George P., was employed by Kirk & Blum, a subsidiary of Ceco Environmental, as a metal fabricator. This employment enabled the Plaintiff to be covered by a group insurance policy provided on behalf of Ceco Environmental employees and insured by Lincoln.

FAQ: Overpayment Issues:
Can a disability company sue me to recover an SSDI overpayment?

This case shows how a long-term disability insurance company can claim an overpayment once a claimant is approved for social security disability income benefits.

Disability Blog & Cases:
Hartford Disability Denial of Insurance Agent with Fibromyalgia and Chronic Fatigue is Reversed

A Utah Federal Judge reversed a Hartford long term disability insurance benefit denial on the basis that it was “unreasonable and, thus, arbitrary and capricious”. The judge’s opinion in this case is a great victory for disability insurance claimants disabled by Fibromyalgia or by…

Disability Insurance Law TV:
Episode 24: Top Five Reasons for Disability Insurance Denials

Nationwide Disability attorneys Gregory Dell and Rachel Alters discuss the top five reasons that Disability Insurance Claims are denied. The information in this video applies to both ERISA and Non-ERISA disability insurance policies.

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.

Disability Blog & Cases:
Medical Doctor suffering from disabling chronic conditions sues AXA Equitable for wrongful denial of disability benefits

A Montana disability lawyer recently filed a federal lawsuit against the AXA Equitable Life Insurance Company (AXA). The Plaintiff, Marise J., M.D., was employed as a licensed medical doctor and was board certified in internal medicine. She had been practicing medicine for over 30 years.

Disability Blog & Cases:
Aetna Disability Denial of Marriott Employee Upheld by Louisiana Federal Judge

A former Marriott Employee was unsuccessful in his lawsuit seeking a reversal of Aetna Life Insurance Company’s disability insurance denial. As a former director of engineering, earning more than $200,000 a year, this former Marriott employee stopped working due to disabling lumbar herniations and back pain…

Disability Blog & Cases:
Who is Making the Decisions on a Sun Life Disability Benefits Claim?

Disability insurance claimants are routinely telling our disability insurance attorneys about their dissatisfaction with the manner in which a disability insurance company has handled their claim for disability benefits. Let’s take a look at why this disappointment is taking place.

FAQ: Tax Issues
How can a claimant exclude their disability insurance benefit payments from Federal Income Tax?

What actions can a claimant take in order to exclude Disability Insurance Benefits from personal income tax?

Aetna Life Insurance Company (Aetna) was recently sued in three cases in the Federal Courts of Oregon, Tennessee, and Missouri by three separate Plaintiffs due to the wrongful denial of long-term disability benefits as covered by the Employee Retirement Income Security Act (ERISA). All three cases claim that Aetna wrongfully denied the rightful long-term disability benefits to the Plaintiffs as defined by the terms of their respective Plans.

The Oregon Case

In Troy R. Vs Aetna Life Insurance Company, Plaintiff was employed as a residential appraiser by Bank of America for the past 20 years. Plaintiff was enrolled in a group long-term disability Plan that was issued by Aetna, who also is the claims administrator of the Plan.

On or about May 6, 2009, Plaintiff became disabled as defined by the terms of the Plan and submitted a timely claim for benefits. Aetna began paying short-term disability benefits on May 6, 2009 and continued doing so until November 3, 2009. Plaintiff provided all information requested by Aetna throughout the process, leading to the initial claim for short-term disability (STD) benefits.

Plaintiff submitted a claim for long-term disability (LTD) benefits, but on November 4, 2009, Aetna denied this claim despite the fact that Aetna had not received any new information about the Plaintiff’s condition from the time the last STD extension was granted on October 20, 2009 to the date that LTD benefits were denied on November 4, 2009.

Plaintiff appealed the denial, adding more reports and medical information to support his claim that the denial should be overturned. However, on November 23, 2010, Aetna made a final administrative denial of the Plaintiff’s appeal and claim for benefits based on "a lack of medical evidence" regarding his condition and his inability to work. Due to exhausting all administrative appeals, Plaintiff has filed this lawsuit against Aetna.

The Tennessee Case

In Eileen S. Vs Aetna Life Insurance Company and Gannet Company, Inc. (Gannet), Plaintiff was employed as a copy editor for the Tennessan, a newspaper based in Nashville, Tennessee and owned by Gannet Company, Inc. Plaintiff was covered under an Income Protection Plan that provide a sick pay program, a short-term disability program, and a long-term disability program. Gannet maintained this program for its employees, while Aetna was the claims administrator.

Due to a disability, Plaintiff ceased working on July 12, 2008. Plaintiff filed a timely claim for STD benefits, which should have been paid between July 19, 2008 and January 10, 2009. Plaintiff’s claim for STD benefits were approved, but only paid through October 30, 2008.

Aetna sent a letter to Plaintiff dated November 12, 008 that terminated her STD benefits due to a lack of documented evidence of her medical conditions. Plaintiff appealed this denial and sent substantial amounts of additional evidence to prove her claim. She also submitted a claim for disability benefits to the Social Security Administration (SSA) as required under the terms of the Income Protection Plan, which was granted a Fully Favorable Decision on April 20, 2010.

Despite this, Aetna issued a final denial of STD and LTD benefits via a December 8, 2010 letter to the Plaintiff. Plaintiff has exhausted all administrative remedies, leading to the filing of this lawsuit against Aetna.

The Missouri Case

In Sandra A. Vs Aetna Life Insurance Company, Plaintiff was employed by Verizon Wireless (Verizon) and was covered by the disability insurance company as provided by Verizon, which was fully insured by Aetna.

Due to her medical conditions, Plaintiff has been totally disabled as defined by the terms of the Plan since November 1, 2009. Plaintiff submitted a claim for benefits, but was denied by Aetna. Plaintiff has exhausted all administrative appeals and has filed this lawsuit against Aetna.

Plaintiffs Seek The Following Relief

In all of the aforementioned cases, Plaintiffs seek the following relief from Aetna:

  • Full entitled benefits as defined by the terms of the Plaintiffs’ respective Plans.
  • All reasonable attorneys’ fees.
  • All related court costs.
  • All other fair and just relief as decided upon by this 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.