In Kathryn McDaniel-Bowen vs Sun Life and Health Insurance Company F/K/A Genworth Life and Health Insurance Company, filed at the District Court for the Eastern District of Arkansas, the plaintiff Kathryn McDaniel-Bowen alleged that the Sun Life and Health Insurance Company (Sun Life) had breached its contractual obligations by denying long term disability benefits payments to her.
The Alleged Facts of the Case
The plaintiff was formerly employed as an office manager for the Buford Media Group, LLC. As a fulltime employee of the Buford Media Group, the plaintiff was covered under a Long Term Disability Insurance Policy issued by Sun Life.
On August 2009, the plaintiff stated that she began to experience pain in the neck and shoulder. Later the pain became constant in her neck, shoulder blade area of her back and lower back. By December 9th 2009, the plaintiff had to stop working because of the severity of her pain. Her disability had resulted in anxiety, depression, extreme fatigue, stress and feelings of worthlessness. According to the plaintiff, these symptoms have prevented her from carrying out the ordinary functions usually performed in her position as an office manager for Buford Media. The plaintiff also stated that these injuries and disabling symptoms have resulted in her inability to perform all the material and substantial duties of her regular occupation and any gainful occupation that she was qualified for or may reasonably become qualified for by education, training or experience.
Consequently, the plaintiff applied to Sun Life for short term disability benefits and received weekly benefits amounting to $564.00 from January 27th 2010 to June 24th 2010. Later the plaintiff submitted a claim to Sun Life for long term disability benefits but was denied her claim. The plaintiff alleged that Sun Life had denied her claim for long term disability benefits without even conducting a medical examination of her.
According to Dr. Robert A. Dorman, M.D, the plaintiff’s attending physician, November 9th 2010 report to Sun Life;
Kathryn McDaniel is a patient of mine. In the matter of your denial of Mrs. McDaniel-Bowen, please allow me to clarify this patient’s problems. This is a degenerative disc disease that has long term and chronic implications along with the acute exacerbations that have been noted during the care provided prior to and after the December 9, 2009 date. This is the date that is officially defined as her first day of disability but attempts prior to that date to continue her in the job from which she was removed were revealing of her inability to stay in that job. She develops intractable pain in her neck while working. There does not appear to be an alternative for her. Exhaustive therapeutic options from therapy to medications to injections have not changed this outcome. I can personally and professionally validate her disability claims and her wish to return to gainful employment but that does not appear likely to happen.
The plaintiff alleged that despite having complied and satisfying all her contractual obligations under the policy, Sun Life had denied her claim and refused to pay any disability benefits. As such, the plaintiff argued that Sun Life had breached the terms of the policy by denying and refusing to pay her claim for long term disability benefits.
Relief Claimed By The Plaintiff
The plaintiff argued that due to Sun Life’s actions, she is entitled to:
- All disability insurance payments due and unpaid since December 9th 2009, plus interest thereon until paid.
- All future disability insurance payments until she reaches the age of 65 as provided for in the policy.
- A reasonable attorneys’ fee and a 12% penalty on all disability benefits awarded by the Court.
- For costs and for all other relief that the plaintiff may be entitled to.
The plaintiff also demanded a trial by Jury.