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Five lawsuits recently filed in Florida Courts against Prudential for non-payment of disability benefits to deserving claimants

With at least five suits filed against them in July, Prudential Insurance Company of America has a lot of unhappy claimants in Florida. Disability Attorneys recently filed Five Lawsuits against Prudential for the denial of long term disability benefits. Let’s take a closer look at each case.

Case 1: Darlene H. v. Prudential Insurance Company

On July 25, 2011, Darlene H. and her attorney filed suit against Prudential when the insurer failed to pay her disability benefits as expected. In the complaint filed in the United States District Court of Florida, Tampa Division, Darlene H. accuses the insurer of having a conflict of interest in deciding whether or not to pay out disability benefits, acting arbitrary and capricious, failing to apply the provisions of their plan consistently, failing to conduct a “full and fair review” of her claim as stipulated in the Employee Insurance Retirement Security Act of 1974 (ERISA), failing to follow their own internal guidelines for determining awards of claimant disability benefits, and failing to comply with laws governing the administering of such disability policies. Darlene H. wants the Court to order the insurer to provide a “full and fair review of (her) claim as well as cover her attorney fees and court costs.”

Case 2: Lisa T. v. Prudential Insurance Company

On July 19, 2011, Lisa T., an employee at Zimmerman & Partners Advertising, Inc. as a Human Resources Director, and her disability attorney filed suit against Prudential in the United States District Court for the Southern District of Florida, Fort Lauderdale Division. Lisa T. became disabled in June 2009 from SLE (Systematic Lupus Erythematosus), chronic and Severe Fatigue, Worsening Memory Loss, Swelling of hands and Feet, Decreased Concentration Status, Chronic Joint Pain, Persistent Erythromelagia, Guillan-Barre Syndrome, Rhematoid Arthritis, Reynaud’s phenomenon and poor sleep. Prudential initially paid Lisa T. long-term disability from December 2009 until May 2010. At that time, Prudential determined that Lisa T. no longer met the definition of disabled and no longer qualified for long-term disability benefits. Still suffering from the debilitating symptoms of SLE, Lisa T. appealed the decision only to be denied again.

Consequently, as a result of the withholding of her entitled disability benefits, Lisa T. and her disability attorney filed a complaint against Prudential alleging that its decision was arbitrary and capricious, and breached the contract the insurer had with Lisa T. Lisa T. and her attorney ask the District Court for an order to force Prudential to fulfill its obligations under Lisa T.’s disability policy and reinstate her benefits plus attorney’s fees.

Case 3: Charles C. v. Prudential Insurance Company

In the July 19, 2011 complaint filed against Prudential Insurance Company by Charles C. and his attorney, the plaintiff, a US Food Service, Inc. Sales/Territory Manager filed for disability benefits when he became disabled in August 2009. Suffering from “gastroenterological symptoms, cervical radiculopathy and Myelopathy and lumbar radiculopathy,” Charles C. was paid long-term disability benefits from February 2010 until August 2010. Claiming Charles C. no longer met its definition of disabled, Prudential terminated Charles C.’s benefits. With ammunition from the insurer’s own doctors, who verified that Charles C. ‘s medical records indicated that Charles C. was limited in his ability to perform his job, Prudential ignored all evidence of Charles C.’s disabling condition and denied all appeals which led to the filing of Charles C.’s lawsuit.

In the complaint Charles C. alleges that Prudential was arbitrary and capricious, ignored the documentation of his condition, breached its contract with Charles C., and “is guilty of bad faith, has been stubbornly litigious, and has cause Charles C. unnecessary trouble, expense, and emotional distress.” Consequently, he asks the Florida District Court to render judgment for Charles C. and against Prudential and force the insure to pay Charles C.’s disability benefits per the terms and conditions of his policy as well as reimburse him for attorney’s fees and court expenses.

Case 4: Arnold R. v. Prudential Financial

A senior vice president and his disability lawyer filed suit against Prudential on August 1, 2011 in the Miami Division of the United State District Court of the Southern District of Florida for unpaid disability benefits. Arnold R., an HIV sufferer since 1992, was the beneficiary of a long term disability insurance policy with Prudential that went into effect in 1982, which was originally administered by his employer Bank of New York. At the time of his diagnosis, Arnold R. was the Senior Vice President of Global Custody and Securities Lending for the Bank of New York. According to Arnold R.’s lawyer, as stated in their complaint, Arnold R. “suffers from debilitating gastrointestinal problems, particularly chronic diarrhea, fatigue, problems with memory and concentration, and peripheral neuropathy in his lets as well as recurring skin conditions and rashes and recurring pulmonary conditions such as pneumonia and bronchitis,” due to his illness and medications he takes to control his HIV infection. Consequently, Arnold R. went on short term disability from Prudential in August of 1992. On May 1, 2005, Arnold R.’s disability benefits administration was taken over by Prudential. And, on January 10, 2006, Prudential terminated Arnold R.’s benefits.

According to Prudential since Arnold R. was original on the Executive Disability Plan, he does not fall under the definition of “disabled” per that plan. Asked for a copy of this document and not receiving that copy, Arnold R. appealed the insurer’s decision to terminate his disability benefits. That appeal and his second appeal were denied, still without the provision of the again requested plan details. Finally in January 2007, Arnold R. was able to procure a copy of the Executive Disability Plan Summary from Bank of New York. However, the plan was not the 1982 version, but the 1995 version. Not able to document that there even was an Executive Disability Plan when Arnold R. began receiving his disability benefits in 1992, Arnold R. is disabled under his plan.

With little progress in pointing out this discrepancy to the disability plans, Arnold R.hired a disability attorney to help him retrieve his rightful disability benefits. In the complaint, Arnold R. claims that Prudential and the Bank of New York have breached their contract with him, that they have failed to provide documents in violation the Employee Retirement Security Act (ERISA) and have asked the Court to order the defendants to pay all his unpaid disability benefits plus interest, pay civil penalties for their failure to provide requested documents to him and his disability attorney, pay him the correct amount of disability benefits had he been subject to the Executive Disability Plan, and pay Arnold R.’s attorney’s fees and Court costs.

Case 5: Nancy P. v. Prudential

On July 14, 2011, Nancy P. and her attorney filed a lawsuit against Prudential to recover her wrongfully denied disability benefits. In the complaint, filed in the United States District Court for the Northern District of Florida, Pensacola Division, Nancy P. and her lawyer allege that the insurer has breached its duty as fiduciary administrator of Nancy P.’s disability plan and has a conflict of interest in taking on the role of administrator to the plan.

Nancy P. was paid disability benefits from December 16, 2009 until March 17, 2010. Then Prudential refused to pay any disability benefits to Nancy P. after March 18, 2010, claiming Nancy P. no longer qualified as disabled. After appealing this decision, Nancy P. turned to a disability lawyer to take her case to District Court. She and her disability attorney ask the Court to award her disability benefits, continuing and unpaid since March 18, 2010, interest, attorney’s fees and a declaration that she meets the disability qualifications under the plan and is entitled to such benefits as provided by the plan.

There are 2 opinions so far. Add your comment now.

Deb:

How can I get the company’s internal guidelines? They say the guidelines are confidential.

Attorney Greg Dell:

Deb,

If a lawsuit is filed, then these documents can be requested through the discovery process.

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