Northwestern Insurance beneficiary Todd W. and his California disability attorney’s complaint against the insurer accuses Northwestern of breach of the Duty of Good Faith and Fair Dealing and Breach of Contract in response to its denial of Todd W.’s disability benefits.
Citing an advertisement of Northwestern Insurance Mutual Life Insurance Company as the reason why Todd W. first purchased a Northwestern benefits policy, Todd W.’s disability attorney accuses the insurer of “hooking” potential disability benefit customers by promising peace of mind, only to breach that trust by failing to deliver disability benefits when beneficiary’s most need them. Having received only a small portion of the disability benefits that he was entitled to from his disabled condition, Todd W. and his attorney state in their complaint that the insurer:
- Unreasonably failed to conduct an impartial vocational review of Todd W.’s disability claim;
- Unreasonably failed to identify any medical personnel who reviewed Todd W.’s disability claim;
- Unreasonable failed to provide copies of internal medical records reviews to Todd W. concerning his disability claim;
- Unreasonably failed to rely upon board certified treating physicians who had examined Todd W. and instead relied upon consultants who only reviewed Todd W.’s medical records; and
- Practiced these unreasonable actions due to financial bias.
Complainant’s disabling condition
A large event consultant, Todd W. applied for disability benefits on his Northwestern policy on November 21, 2007. After awarding Todd W. disability benefits and paying those benefits through August 2008, Northwestern terminated Todd W.’s disability award, claiming Todd W. was no longer disabled. However at the time of this termination Todd W. continued to suffer from complications of facial paralysis, a viral infection that “has left him virtually deaf in one ear, and tinnitus.” Having fully cooperated with the insurer and providing medical records to support his disabling condition Todd W. exhausted all his administrative appeals and has been forced to hire a disability attorney and file suit against Northwestern to get his rightfully deserved disability benefits.
Northwestern Mutual terminates claimant’s disability benefits
Having unreasonably terminated Todd W.’s disability benefits, Northwestern is accused of breaching its duty of good faith and fair dealing with Todd W. and causing him unnecessary suffering as a result of the financial stress the insurer has caused Todd W. In the subject complaint, Todd W.’s attorney states that Northwestern’s treatment of Todd W. as “despicable conduct carried on by [Northwestern] with a willful and conscious disregard of the rights of [Todd W.].” In addition, the attorney for Todd W. claims that as a result of the insurer’s breach of its contract with Todd W., Todd W. has been damaged and he and his client request that the Court force Northwestern to repair the damage it has caused to Todd W. by:
- Paying Todd W. damages for unpaid disability benefits, with interest;
- Paying general damages for “mental and emotional distress”;
- Paying for Todd W.’s attorneys‘ fees to settle this issue;
- Paying punitive damages to Todd W.;
- Paying court costs; and
- Compensating Todd W. with any other damages as the Court sees fit.