Long-term disability benefits terminated: ERISA violations: wrongful termination of benefits: lost benefits: judgment

Law Reporter
February 2006

Davidson v. Metropolitan Life Ins. Co., U.S. Dist. Ct., C.D. Cal., No. SACV04-1151 DOC (Anx), Sept. 2, 2005

Davidson, 57, had a long term disability policy through his employer. In 1984, he developed a multilevel degenerative disk disease that caused him constant pain and prevented him from continuously sitting or standing too long. He began receiving disability benefits in 2000. In 2003, the insurer started videotaping Davidson’s activites and canceled the benefits after concluding he was no longer disabled. He suffered lost past unpaid benefits of over $100,000.

Davidson sued the insurer, alleging violations of the Employee Retirement Income Security Act (ERISA), 29 U.S.C. 1001 et seq. Plaintiff alleged defendant abused its discretion because it wrongfully terminated his benefits without an examination by its physician and ignored medical documentation submitted by the physicians who did examine him and who determined that he was totally disabled. Plaintiff further contended the disability surveillance did not show him doing anything he had claimed to be unable to do.

The court ruled in favor of the plaintiff, finding that defendant abused its discretion by ignoring the medical evidence establishing plaintiff’s total disability. The court awarded plaintiff about $120,000, plus interest and attorney fees and costs. The court also reinstated plaintiff’s benefits until he can resume work.

Similar / Related:

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• Northwestern Mutual Life Insurance Company denies partial disability benefits to trial attorney resulting in lawsuit for violations of Washington Insurance Fair Conduct Act

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