Disability Blog & Cases:
30 year veteran employee of 3M Company sues company and Sedgwick Insurance for disability benefit denial

An employee of 3M Company as a Key Account Manager for 30 years, Dominic D. LaPorta was shocked to find out that his security net disability insurance plan was not so secure when Sedgwick Claims Management failed to meet its obligations to provide him disability benefits should he become disabled while working at 3M Company. With no other options available to resolve his issue with 3M Company and Sedgwick, LaPorta engaged the services of a disability attorney and filed a lawsuit against 3M and Sedgwick, alleging ERISA violations, on May 27, 2011 in the United States District Court of Minnesota.

Disability Blog & Cases:
Insurance sales agent files a disability insurance denial lawsuit against Liberty Life Assurance Company of Boston

Ricky C. Hampton, an insurance sales agent with Alfa Mutual Insurance Company (Alfa) has filed a lawsuit against his own disability insurance company, Liberty Life Assurance Company of Boston. A position described as light, Hampton was required to work forty hours per week, five days a week and was frequently asked to perform the following duties, all of which were documented in his job description.

Disability Blog & Cases:
Sun Life Insurance Company is sued for disability benefits in two separate cases for arbitrary and capricious denial of disability claims

With disability insurance lawsuits occurring up and down the eastern US coastline, Sun Life Insurance Company has a lot of litigation to settle. Just in May 2011, Sun Life was hit with two complaints from disability insurance benefits claimants, one in the United States District Court District of New Jersey (Kevin Giblin v. Sun Life and Health Insurance Company et. al) and the other in the United States District Court for the District of South Carolina, Spartanburg Division (Duane Easler v. Sun Life Assurance Co. et al.).

Disability Blog & Cases:
Xerox employee is denied her long term disability benefits and sues Sedgwick and Xerox

An employee of Xerox Corporation files a lawsuit against Sedgwick Claims Management Services, Inc., Sedgwick Claims management Services, Inc., and The Prudential Insurance Company of America for disability benefits. An employee with Xerox for 10 years, Andrea Calhoun brought a lawsuit against her employer and Sedgwick under the Employee Retirement Income Security Act of 1974 (ERISA) 29 U. S. C. § 1001, et seq. "seeking to overturn a denial by the Defendant" of her long term disability benefits.

Disability Blog & Cases:
CIGNA Group Insurance and Subsidiaries sued in Alabama, New York and Michigan for allegedly acting arbitrarily and capriciously in denying claims for long term disability benefits

Recently, the CIGNA Group Insurance and its subsidiaries (CIGNA) faced a barrage of disability insurance lawsuits filed against the company and its subsidiaries across the country allegedly for denying long term disability (LTD) benefits by ignoring overwhelming medical evidences that supported the plaintiffs’ disabled condition.

Delicia Haynes, an employee of Commercial Metals Company has filed a lawsuit against Liberty Life Assurance Company of Boston to collect her long overdue disability benefits. A data entry clerical assistant at Commercial Metals Company, Haynes was denied her disability application for long term disability in a letter from Liberty Life Assurance, dated March 13, 2010. In the letter, Liberty Life denied Haynes claim but also failed to state "any material or information" that was necessary for Haynes to file an ERISA appeal. The insurer’s letter did reference some of Haynes general documents, without stating why her claim was denied.

Baffled Employee Appeals Disability Claim Without Adequate Information

Without the necessary information to do so, Haynes appealed Liberty Life’s denial of her disability claim on August 30, 2010 to no avail, as Liberty Life failed to respond to the appeal at all. Along with her appeal paperwork, Haynes provided Liberty Life with additional documentation to verify her disability and complied with all the requirements to file an ERISA administrative appeal under Liberty Life’s Plan.

Haynes And Her Texas Disability Attorney File Her Lawsuit Against Liberty Life

As a result of Liberty Life Assurance’s inaction to address Haynes administrative disability benefits appeal, Haynes engaged the services of a Texas disability lawyer and filed a lawsuit against Liberty Life Assurance in the United States District Court of the Northern District of Texas, Fort Worth Division to seek a judgment on her disability claim.

Haynes’s Complaint

In her complaint, Haynes and her Texas disability attorney allege that 47-year-old Haynes "is entitled to LTD benefits under her Policy," has complied with proof of her disability claim according to the Policy and is entitled to receive long term disability benefits until age 65. Haynes’s complaint also alleges that Liberty has violated several regulations of the Secretary of Labor by not giving Haynes adequate reason for its original denial of her disability benefits, failing to provide her with a full and fair review of her disability claim, failing to provide her with information to allow for an appeal of the denial, failing to administer Haynes’s plan in a way that benefits participants, operating under a conflict of interest, failing to have Haynes’s claim reviewed by a proper reviewer, and failing to act by responding to Hanes appeal.

In addition, Haynes and her Texas disability lawyer allege that Liberty Life violated ERISA regulations by failing to review her claim properly and being "arbitrary and capricious" in the handling of her claim. Haynes’s Texas disability lawyer points out that Liberty Life didn’t have Haynes’s claim reviewed by an appropriate healthcare professional but used a biased consultant instead, gave inappropriate feedback to Haynes’s claim making it virtually impossible for her to appeal, didn’t follow their own guidelines in the evaluation of Haynes’s claim, and in essence chastises the insurer for its handling of all claims.

What Haynes Asks The District Court To Do About Her Disability Benefits Claim

Haynes asked the District Court for the Northern District of Texas, Fort Worth Division to force Liberty Life to provide her with her entitled employee disability benefits, both past due and future, pre-judgment and post-judgment interest, Court costs, attorney’s fees and any other further relief the Court thinks is proper under the circumstances.

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:
Disabled Unisys network design engineer sue Aetna Life Insurance Company seeking payment of long term disability benefits

Through a Utah disability insurance lawyer, a lawsuit was filed at the District Court for the District of Utah by a disabled Network Design Engineer formerly working at Unisys. In the lawsuit, it was claimed that the Aetna Life Insurance Company’s (Aetna Life) failure and refusal to pay the plaintiff long term disability (LTD) benefits under an employee welfare benefit plan underwritten and insured by Aetna Life constituted a breach of the terms and provisions of the Plan and of the Employee Retirement Income Security Act of 1974 (ERISA).

Disability Blog & Cases:
Former Charles Schwab Corporation employee sues Liberty Life Assurance Company of Boston for denial of long term disability benefits

A Kentucky disability lawyer recently filed a lawsuit against the Liberty Life Assurance Company of Boston (Liberty Life) at District Court for the Eastern District of Kentucky. In Rita Dirks Vs Liberty Life Assurance Company Of Boston, The Charles Schwab Corporation Long Term Disability Plan And The Charles Schwab Corporation, it was alleged by the plaintiff Rita Dirks that Liberty Life had violated the provisions of the Employee Retirement Income Security Act of 1974 (ERISA) in the handling of her claim for long term disability (LTD) benefits.

Disability Blog & Cases:
Cigna denies disability benefits to former Healthsouth Corporation nurse after paying for 11 years

In Susan Sheehan Vs Cigna Group, Life Insurance Company of North America, a Massachusetts disability attorney filed a lawsuit at the District Court District Of Massachusetts claiming that the giant disability insurance company Cigna Group (Cigna), had contravened the provisions of the Employment Retirement Income Security Act (ERISA) in its handling of a client’s claim for disability benefits.

Disability Blog & Cases:
Prudential terminates disability benefits of traumatic brain injury claimant in a case of mistaken identity

James H. White filed a lawsuit against Prudential Insurance of America in the United States District Court For The Eastern District of Pennsylvania for the insurer’s termination of White’s disability benefits after paying him disability benefits for twenty-four (24) months. Claiming that White’s disability was the product of a pre-existing metal illness, Prudential Insurance terminated White’s disability benefits because his policy with Prudential only allows 24 months of disability benefits when the disabling condition is related to a mental illness.

Disability Blog & Cases:
Sunlife denies disability benefits to Wise Foods employee disabled by cancer and shoulder surgeries

John McGinnis has filed a lawsuit against Sun Life Assurance Company of Canada because the insurer denied him his disability insurance benefits and life insurance coverage as dictated by ERISA 29 U.S.C. § 1001 et seq. According to the Complaint that McGinnis and his disability attorney filed in the United States District Court of New Jersey when the insurance company denied him his disability benefits and life insurance benefits the insurer was fully aware of McGinnis’s history of longstanding medical conditions that entitled him to disability benefits when it denied him disability benefits.

In Lamont Philip Richardson Vs Unum Group Corporation And First Horizon National Corporation, the disability insurance claimant alleged that he was improperly denied of his claim for long term disability (LTD) benefits by Unum. A lawsuit was filed for the recovery of disability benefits under an employee benefits plan and for enforcement of rights under the Employee Retirement Security Act of 1974 (ERISA) at the District Court for the Eastern District of Tennessee by a Tennessee disability attorney.

The Nature of the Lawsuit Against Unum Insurance

The plaintiff Lamont Philip Richardson was employed at the First Horizon National Corporation through the First Tennessee Bank at Memphis, Tennessee. By virtue of his employment, the plaintiff was a participant of an employee benefits plan maintained by the First Horizon National Corporation for the benefit of its employees and in which Unum was the Claims Administrator. The disability plan provides LTD coverage in the event of disability.

According to the disability lawsuit, the plaintiff became eligible to receive LTD benefits on May 31st 2008. The plaintiff stated that his UNUM disability application was approved and he began receiving LTD benefits from Unum beginning from May 31st 2008 until June 15th 2010. From the period of June 16th 2010 to September 15th 2010, the plaintiff was paid "extra-contractual benefits” by Unum.

Denial of Long Term Disability Benefits by Unum

On June 16th 2010, the plaintiff alleged that he was improperly denied his claim for LTD benefits. Subsequently, the plaintiff appealed Unum"s decision to deny him his claim for LTD benefits and submitted additional medical documentation to support his appeal. In the lawsuit, the plaintiff also stated that, on November 10th 2010, he was determined to be disabled by the Social Security Administration (SSA). Nevertheless, on March 8th 2011, Unum upheld its prior decision to deny the plaintiff his claim for LTD benefits.

The plaintiff argued that Unum had failed to accord proper consideration to SSA Administrative Law Judge"s determination of disability. The plaintiff also alleged that Unum had arbitrarily disregarded the medical opinions of his attending physicians and instead relied upon opinions of non-examining medical sources engaged by Unum in making its determination to deny the plaintiff"s claim for LTD benefits.

The plaintiff contended that the plaintiff"s treating physician(s) opinions/ restrictions/limitations as well as the SSA Administrative Law Judge"s determination of disability indicated that he was/is unable to perform any occupation. The plaintiff argued that Unum had failed to provide disability benefits that was due to the plaintiff under the terms of the Plan and that this denial of benefits was a breach of the plan as:

  • The decision to deny benefits was wrong under the terms of the Plan.
  • The decision to deny benefits and the decision-making process was arbitrary and capricious.
  • The decision to deny benefits was not supported by the substantial evidence in the record, and failed to give substantial weight to the conclusions of the SSA Administrative Law Judge determination of disability in the plaintiff"s case.

Relief Sought By the Plaintiff

As a result of Unum"s actions, the plaintiff argued that this have resulted in him suffering damages. In addition, the plaintiff has exhausted all his administrative remedies and is seeking from the Court the following relief:

  • Damages for unpaid benefits in the amount equal to the disability income benefits to which he was entitled through the date of judgment.
  • An award of Prejudgment and post judgment interest.
  • An Order requiring the Plan, the Plan Administrator, or appropriate Plan fiduciary to pay continuing benefits in the future so long as the plaintiff remains disabled under the terms of the Plan.
  • An Order requiring the Plan, Plan Administrator, or appropriate Plan fiduciary to provide the plaintiff with ancillary benefits to which he may be entitled due to a finding of disability for so long as the plaintiff remains disabled under the terms of the Plan.
  • An award of reasonable attorney fees and costs.
  • Any other such relief deem by the Court as just and proper.

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:
Disabled project manager for RTP Technology Corporation filed lawsuit against the UNUM Life Insurance Company of America for refusal to pay disability benefits

A New Jersey disability attorney recently instituted a lawsuit against the UNUM Life Insurance Company of America (UNUM) at the District Court for the District of New Jersey of behalf of a disabled client. In Robert Garozzo v UNUM Life Insurance Company of America and RTP Technology Corporation long term disability plan, the plaintiff Robert Garozzo is seeking payment of disability income benefits from UNUM under the terms of a long term disability Benefit plan.

Disability Blog & Cases:
Disabled interventional radiologist with sleep apnea and cardiac limitations sues Unum Provident and Hartford Life for denial of long-term disability benefits payments

For a disability insurance contract, one of the most important clauses in the contract will be the “own occupation” definition of what constitutes disability. The implication of this clause is that if you become “disabled” due to sickness or injury and are unable to work in your specific line of work, the insurance policy will pay you disability benefits even if you decide to work in another line of employment.

Disability Blog & Cases:
AT&T employee with back injury sues Sedgwick Claim Management Services, Inc. for denial of short term disability benefits

Florida Disability Lawyer Sues Sedgwick Claim Management Services

In the case of Richard Shane Burnett Vs Sedgwick Claim Management Services, Inc. D/B/A AT&T Integrated Disability Service Center, filed at the District Court for the Middle District of Florida, the plaintiff Richard Shane Burnett alleged that he is eligible for short term disability (STD) benefits under an employee benefit plan provided by his employer.

Disability Blog & Cases:
Unum Insurance claims no object evidence exist and denies disability benefits to St. Anthony Central Hospital nurse suffering from fibromyalgia

Colorado disability lawyer files lawsuit against Unum Life Insurance Company Of America for denying long term disability benefits and wrongfully asserting no objective test exist to diagnose fibromyalgia

In Kelly Ann Curtis vs Unum Life Insurance Company of America, a Colorado disability attorney filed a lawsuit on behalf of a disability claimant against the Unum Life Insurance Company of America (Unum) at Denver County District Court. The case is quite interesting as it illustrates how disability insurance companies can, by applying certain limiting clauses in disability insurance contracts, avoid paying out disability benefits to the insured.

Disability Blog & Cases:
Fifth Circuit Court Of Appeal denied Estate Of Pepsiamericas, Inc.’s employee motion to recover accidental death and dismemberment benefits from group disability insurance plan issued by Unum

Recently the Court of Appeal Fifth circuit rendered their opinion in the case of Mary Ann LETTER, Individually and as Executrix Administratrix of the Estate of Timothy D. Letter vs. UNUM PROVIDENT CORPORATION; Unum Life Insurance Company of America. They ruled that the plaintiff Mary Ann Letter, individually and as acting as the estate of her husband Timothy D. Letter was not entitled to recover Accidental Death And Dismemberment (AD & D) benefits from her deceased husband’s group insurance plan due to non payment of premium.

Disability Lawyer Files Lawsuit Against Liberty Mutual

In the case of Georgia Lewis Vs Liberty Life Assurance Company Of Boston, Wachovia Corporation And Wachovia Corporation Long Term Disability Plan, the plaintiff filed a lawsuit against the Liberty Life Assurance Company Of Boston (Liberty Life) at the District Court For The District Of New Jersey. In the lawsuit, the plaintiff alleged that Liberty Life had violated the provisions of the Employee Retirement Income Security Act of 1974 (ERISA). The lawsuit was brought against Liberty Life to recover disability income benefits that were due under an employee welfare benefit plan in which Liberty Life was designated as the Claims Administrator and Claims Fiduciary of the Plan.

The Alleged Facts of The Case Against Liberty Life

The plaintiff Georgia Lewis was a former employee of Wachovia Corporation. While as an employee of Wachovia Corporation, she participated in the Wachovia Corporation Long Term Disability Plan in which the Wachovia Corporation acted as the sponsor and plan Administrator. Liberty Life was the Claims Administrator for this plan.

The Claim For Disability Benefits

On January 5th 2006, the plaintiff ceased working as a result of disabling impairments due to suffering from fibromyalgia, ulnar neuropathy of the left arm, and cubital tunnel syndrome. The plaintiff later filed a claim for benefits claiming that she had met the Plan’s definition of "total disability" as she had been rendered unable to perform the material duties of a her occupation.

Initially her disability application for disability benefits was approved by Liberty Life and she received payment of benefits from Liberty Life until November 23rd 2009. On November 23rd 2009, Liberty Life terminated the plaintiff’s benefits on the ground that she did not meet the plan definition of being disabled anymore.

The Appeals To The Termination Of Benefits

In the lawsuit, the plaintiff alleged that her medical condition had not changed and that she has been totally disabled until the present time. She later submitted an appeal to Liberty Life’s decision to deny her disability benefits. Several medical documentations from her attending physicians attesting to her "total disability" condition were also submitted to support her appeal. Nevertheless, on July 14th 2010, Liberty Life informed the plaintiff of its decision to reaffirm the denial of benefits.

Another appeal was later submitted to the Wachovia Long Term Disability Appeal Committee which on November 9th 2010 informed the plaintiff of its final determination reaffirming the decision to deny benefits to the plaintiff.

Relief Sought By The Plaintiff In The Lawsuit

The plaintiff alleged that Liberty Life’s determination that the plaintiff was not totally disabled was not based on evidence and is contrary to the welfare of the plan. The plaintiff further alleged that Liberty Life’s actions in handling and determination of the Plaintiff‘s claim were arbitrary and capricious. Due to the final determination by Liberty Life, the plaintiff has exhausted all her administrative remedies and is asking the Court to review the matter and enter judgment in favor of her. The plaintiff is specifically asking the Court for the following relief:

  1. An Order to Liberty Life to pay disability income benefits to the Plaintiff in an amount equal to the contractual amount of benefits to which the Plaintiff is entitled.
  2. An Order to Liberty Life to pay the Plaintiff prejudgment interest on all benefits that have accrued prior to the date of judgment;
  3. An Order to Liberty Life to continue paying the Plaintiff benefits until such time as she meets the policy conditions for discontinuance of benefits;
  4. An Award of attorney’s fees pursuant to 29 U.S.C. §l l32(g); and
  5. Award any and all other relief to which she may be entitled, as well as the costs of suit.

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:
Washington disability attorney filed lawsuit against the Hartford Insurance Company for denial of long term disability benefits to mentally disabled woman

A Washington disability attorney recently filed a lawsuit on behalf of his client at the District Court for the Eastern District of Washington against the Hartford Insurance Company (Hartford). In the case of Robin (Hunt) Hankel v The Hartford Insurance Company /The Hartford Financial services Group, the plaintiff was a woman employed in the health Safety and Environmental Management/ Engineering field for Harpers. While employed with Harpers, she contributed to a disability insurance plan which was issued by Hartford.

Disability Blog & Cases:
Fort Dearborn Life Insurance Company faces disability denial lawsuit from disabled account clerk of Katz Insurance Group diagnosed with PTSD

Recently, a former account clerk of the Katz Insurance Group filed a lawsuit against the Fort Dearborn Life Insurance Company (Fort Dearborn Life) through a Maryland disability attorney at the District Court for the District of Maryland. In the case of Tosha Pederson v Fort Dearborn Life Insurance Company, the plaintiff alleged that Fort Dearborn Life had acted arbitrarily and capriciously in its decision to deny the plaintiff’s claim for long term disability (LTD) benefits.

Disability Blog & Cases:
Northwestern Mutual Life Insurance Company denies partial disability benefits to trial attorney resulting in lawsuit for violations of Washington Insurance Fair Conduct Act

The Northwestern Mutual Life Insurance Company (Northwestern Life) was recently sued by a Washington disability lawyer for the violations of the Washington Insurance Fair Conduct Act and Washington Consumer Protection laws. In Kurt D. Bennett v The Northwestern Mutual Life Insurance Company, the plaintiff alleged that Northwestern Life in denying the plaintiff’s claims for disability benefits was in violation of the above mentioned laws and breached the terms of the disability insurance policy.

Disability Blog & Cases:
Disabled employee of University Of California Davis diagnosed with fibromyalgia sues Liberty Mutual for denial of disability benefits and seeks punitive damages

Recently a California disability attorney filed a lawsuit against the Liberty Life Assurance Company of Boston (Liberty Life) at the Superior Court of the state of California. In the case of Cassie Ray v Liberty Life Assurance Company of Boston, the plaintiff alleged that by denying the plaintiff’s claim for disability benefits, Liberty Life, among other things, had caused the plaintiff to suffer damages. This disability policy is not governed by ERISA as the claimant is a government employee.

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

In two recent separate cases, an employee of Wells Fargo & Company (Wells Fargo) and an employee of Filtrona Greensboro, Inc. filed lawsuits in California and North Carolina respectively, through their disability attorneys, against the Liberty Life Assurance Company of Boston (Liberty Life) for violations of the provisions of Employee Retirement Income Security Act (ERISA).

California disability Lawyer Sues Liberty Mutual

In the case of Melinda Martinez v Wells Fargo Long Term Disability Plan & Liberty Life Assurance Company of Boston, the plaintiff’s California disability attorney filed the lawsuit at the District Court for the Southern District of California. The lawsuit alleged that Liberty Life contravened the provisions of ERISA and the plaintiff is seeking relief from the Court for the violations of her legal rights under an employee benefit plan issued by Liberty Life.

The Nature of the Complaint

The plaintiff Melinda Martinez was an employee of Wells Fargo and participated in a Long Term Disability (LTD) plan issued by Liberty Life. While employed with Wells Fargo, the plaintiff became disabled as defined by the LTD plan and hence was entitled to the benefits under the LTD plan. The plaintiff attempted to make a claim for LTD benefits under the LTD plan but was denied by Liberty Life on the grounds that the plaintiff was not disabled. Pursuant to the denial of the claim, the plaintiff made an appeal to Liberty Life’s decision to deny her LTD benefits. However, despite overwhelming evidence indicating that the plaintiff was disabled, Liberty Life upheld its decision to deny LTD benefits to the plaintiff. At the same time, Liberty Life also informed the plaintiff that her rights to appeal under the LTD plan had been exhausted.

The plaintiff alleged that the Wells Fargo Long Term Disability Plan and Liberty Life had wrongfully denied her claim for LTD benefits by:

  • Failing to pay LTD benefit payments to the Plaintiff while knowing that her disability was not a pre-existing condition and she was entitled to those benefits under the LTD plan.
  • Withholding the LTD benefits from the plaintiff while aware that the plaintiff’s claim was valid.
  • Failing to provide a reasonable explanation for the denial of LTD benefits
  • Failing to properly advise and explain to the plaintiff any additional material or information necessary for the Plaintiff to perfect her claim.
  • Failing to properly investigate the plaintiff’s claim.

Request for Relief

Having exhausted her administrative remedies, the plaintiff is seeking the following relief from the Court:

  • All disability benefits due to the plaintiff including any and all prejudgment and postjudgment interest;
  • Interest on past due benefits at the rate of 10% per annum as stipulated by the California Insurance Code;
  • A declaration that the plaintiff is disabled under the terms of the LTD plan and entitled to receive benefits for the same while the plaintiff is, was and continues to remain disabled;
  • Or, in the alternative, an order overturning the denial and remanding the case to Liberty Life and the LTD plan for further adjudication under the correct legal standard;
  • An award of Attorney Fees and Costs;
  • And other and further relief as the Court deems just and proper.

North Carolina Disability Lawyer Sues Liberty Mutual

In the case of Barbara Newkirk-Davis v Liberty Life Assurance Company of Boston and FIL Holdings Corporation Group Disability Income Policy, the lawsuit was filed at the Superior Court for County of Guilford, North Carolina by a North Carolina disability attorney for the plaintiff Barbara Newkirk-Davis.

The Alleged Facts of the Case

The plaintiff Barbara Newkirk-Davis was employed as a Quality Assurance Auditor for Filtrona Greensboro, Inc. While employed with Filtrona Greensboro, Inc., the plaintiff participated in an employee welfare benefit policy known as "FIL HOLDINGS CORPORATION GROUP DISABILIY INCOME POLICY" (hereinafter "FIL Policy") that was sponsored by Filtrona Greensboro, Inc and issued by Liberty Life.

FIL Policy acted as the plan administrator while Liberty Life provided claims administration and services for the FIL POLICY and its beneficiaries. On November 11th 2009, due to severe depression, the plaintiff stopped working. She filed a claim for LTD benefits and was approved for payment of LTD benefits in the amount of $2318.00 per month until August 9, 2010.

On August 9th 2010, the plaintiff alleged that FIL Policy and Liberty Life, without any basis, and disregarding the conclusions of the plaintiff’s doctors, terminated the plaintiff’s LTD benefits effective from August 10th 2010. The plaintiff timely appealed the decision to terminate her LTD benefits but however was unsuccessful in her appeal on October 27th 2010.

The plaintiff argued that FIL Policy and Liberty Life had acted arbitrarily and capriciously and purposely ignored the qualified opinions, findings and conclusions of Plaintiff’s doctors in their handling of Plaintiff’s claim for LTD benefits. She further claimed in the lawsuit that that they had abused their discretion and acted with self interest whilst administrating her claim for LTD benefits. The plaintiff alleged that she remains disabled and based on her doctors’ findings "is unable to perform the duties of any gainful occupation for which she is reasonably qualified by education, training or experience."

Relief sought by the Plaintiff

Having exhausted her administrative remedies, the plaintiff is bringing a "…civil action to recover benefits due to her under the terms of the Policy, to enforce her rights under the terms of the Policy and/or to clarify her right to benefits under the terms of the Policy" under ERISA. As such, the plaintiff is asking the Court for the following relief:

  • A declaration that FIL Policy and Liberty Life have violated the terms of the Policy denying and refusing to pay Plaintiffs long term disability benefits under the Policy;
  • An order to compel FIL Policy and Liberty Life to pay Plaintiffs long term disability benefits pursuant to the terms of the Policy;
  • A declaration of the plaintiff’s rights to receive future LTD benefits;
  • An award of prejudgment interest on all damages requested;
  • An award of reasonable attorney’s fees and costs;
  • Any other and further relief as the Court deems necessary and proper. 

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.

June 22, 2011 – A recent opinion from the Ninth Circuit United States Court of Appeals has helped clarify the rules as to who you can sue in actions for benefits under a long term disability policy See Cyr v. Reliance Standard & Channel Technologies, 2011 WL 2464440, June 22, 2011. The Court concluded that under appropriate circumstances, an entity other than the plan itself or the plan administrator may be sued under 29 U.S.C. § 1132(a)(1)(B).

Laura Cyr was employed by Channel Technologies, Inc. ("CTI") as a vice president. CTI provided its employees with long term disability benefits under a program insured by defendant Reliance Standard Life Insurance Company ("Reliance"). CTI was the plan administrator, and Reliance effectively controlled the decision whether to honor or deny a claim for benefits. In October 2000, Cyr filed a claim for long term disability benefits based on a back condition. Reliance approved the benefits and based her monthly payment on her salary of $85,000/year.

Ms. Cyr later filed suit against her employer, CTI, alleging gender discrimination. A settlement agreement was eventually reached which awarded Cyr a retroactive salary of $155,000/year. When Cyr asked Reliance to increase her monthly benefit amount in accord with her adjustment in salary, Reliance declined. Cyr was forced to file suit to pursue her claim for the increased benefits.

Cyr filed suit against Reliance, the CTI Group Long Term Disability Benefit Program (the ‘Plan’), and CTI as the plan administrator for the Plan. Reliance moved for summary judgment, arguing that only the plan or plan administrator could be held liable under the statute. Initially, the district court agreed with Reliance, but later the court changed its mind and ruled in favor of Cyr. Cyr was awarded fees, costs and interest on the money owed. In light of this ruling, Reliance appealed.

The issue for the Appellate Court was whether Reliance was a proper defendant in a suit for benefits under 29 U.S.C. § 1132(a)(1)(B) even though it was neither a plan or plan administrator. The Court first noted that neither 29 U.S.C. § 1132(a)(1)(B) nor 29 U.S.C. § 1132 stated any limits about who could be sued. Additionally, the Appellate Court looked to a United States Supreme Court ruling for guidance. In Harris Trust & Savings Bank v. Salomon Smith Barney, Inc., 530 U.S. 238 (2000), the Supreme Court addressed a similar question of who can be sued under a similar statute, 29 U.S.C. § 1132(a)(3). In that case, the Supreme Court noted that 29 U.S.C. § 1132(a)(3) makes no mention at all of which parties may be proper defendants. The Court then ruled that there was no limit in 29 U.S.C. § 1132(a)(3) as to who could be sued.

Similarly, in the case at hand, the Appellate Court felt that because 29 U.S.C. § 1132(a)(1)(B) contained no limitation as to who could be sued, the Court could not read a limitation into the statute. The Court concluded that parties other than plans can be sued for money damages as long as that party’s individual liability is established. The Court looked to related section 29 U.S.C. § 1132(d)(2) which provides that ‘any money judgment under this subsection against an employee benefit plan shall be enforceable only against the plan as an entity and shall not be enforceable against any other person unless liability against such person is established in his individual capacity under this subsection.’

In the case at hand, the Court determined that Reliance, as plan insurer who is responsible for paying legitimate benefits claims, is a logical and proper defendant for Cyr to recover benefits due, along with the plan and the plan administrator. The Court denied Reliance’s appeal.

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:
Anesthesiologist files lawsuit against Paul Revere Life Insurance Company alleging wrongful deduction of social security retirement benefits

On April 29, 2011, Dr. Phillip W. Watson and his disability attorney filed a lawsuit in the United States District Court Southern District of Florida as a last resort to settle Watson’s claim that in violation of ERISA, Title 29, United Stated Codes 1000-1461, Paul Revere Life Insurance Company arbitrarily decided to deduct part of his disability benefits payments when Watson applied for his early Social Security retirement benefits (SSR).

Disability Blog & Cases:
A former HCBS sales manager diagnosed with lyme disease sues UNUM Life Insurance for disability claim denial

Mark Linder filed a lawsuit against UNUM Life Insurance Company of America (UNUM) in the United States District Court for the Middle District of Pennsylvania under ERISA, 29 U.S.C. § 1132. Linder was forced to seek Court mandated relief when his disability claim was denied by UNUM even though he was classified as totally disabled by his medical provider.

Disability Blog & Cases:
UNUM denies disability insurance benefits to disabled nurse with fibromyalgia and osteoarthritis

Claiming four counts of misconduct by UNUM Life Insurance Company in the denial of her disability claim, Cynthia A. Keller filed a lawsuit on May 2, 2011 in the Eastern District of Michigan Southern Division. After exhausting all her administrative appeals to the insurance provider, Keller hired a Michigan disability lawyer who prepared her complaint stating that UNUM is guilty of breaching its obligations under ERISA, asking for injunctive and declaratory relief, requesting pre-judgment and post-judgment interest, and reimbursement for her attorneys’ fees.