Clopay Corporation Customer Service Representative Sues Prudential For The Wrongful Denial Of Long-Term Disability Benefits

An attorney recently filed a federal lawsuit in the Ohio district court against The Prudential Insurance Company of America (Prudential) and Clopay Corporation Long-Term Disability Coverage (Clopay). The Plaintiff, Kimberly G., was employed as a Customer Service Representative at Clopay Corporation, providing her with short-term with Principal Financial and long-term disability benefits with Prudential.

In Kimberly S. v. The Prudential Insurance Company of America and Clopay Corporation Long-Term Disability Coverage, Plaintiff seeks long-term disability benefits she is entitled to that were wrongfully denied by Prudential.

Facts of the Case Against Prudential and Clopay

Plaintiff was employed as a Customer Service Representative with Clopay until October 2008 when she was forced to stop working due to degenerative disc disease, foraminal stenosis, retrolisthesis, and spondylosis in her neck, along with degenerative disc disease in the lumbar spine at L5-S1.

Plaintiff made a claim for benefits under the Plan on October 7, 2008. Principal paid the short-term disability benefits for the following 26 weeks because she could not perform the duties of her own occupation.

Plaintiff was expecting to receive long-term disability benefits from Prudential beginning April 5, 2009. However, Prudential denied her claim on March 8, 2010, citing that she was late in filing her claim, she was not disabled through the elimination period, and she was not disabled at the time when her long-term disability benefits were to begin.

Plaintiff filed an administrative appeal that challenged this denial via hired counsel through an extensive appeal that was sent to Prudential on November 3, 2010. This appeal included sworn testimony from Plaintiff’s treating physician, updated medical records from all of the Plaintiff’s treating physicians, medical descriptions, and more.

On September 30, 2010, Plaintiff underwent a lumbar fusion surgery, with the results being sent to Prudential at their request. Despite this, however, Prudential again denied Plaintiff’s claim on March 8, 2011, basing this mostly on two physicians who claimed that Plaintiff could have worked in a sedentary occupation until Plaintiff’s lumbar fusion surgery on September 30, 2010.

Prudential gave Plaintiff a second voluntary appeal, which allowed Plaintiff to submit a second appeal on August 29, 2011. This appeal included a full copy of the short-term disability file as produced by Principal, updated medical records from two of Plaintiff’s treating physicians, and a letter from Clopay regarding discrepancy in Plaintiff’s rate of pay.

Prudential sent this information to the same physicians who reviewed the medical information in the first appeal. The new information did not change the physicians’ prior opinions. As a result, Prudential denied this second appeal on October 26, 2011. Plaintiff has exhausted all administrative remedies and has filed this lawsuit against Prudential.

Lawsuit Filed Against Prudential For Denial Of Long-Term Disability Benefits

The lawsuit claims that Prudential committed the following wrongful actions against the Plaintiff:

Plaintiff Seeks Following Relief From Prudential

Due to the unreasonable and wrongful actions of Prudential, Plaintiff asks for the following relief from the Court:

DISABILITY INSURANCE COMPANY INFORMATION
Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

View videos, articles, resolved cases and claimant reviews about your specific disability insurance company.

Leave a comment or ask us a question

FAQ

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

Reviews

Bruce R. (Arizona)

Steve Dell has done an exceptional job with my disability application process. The firm is extremely well managed. They have acquired an incredible amount of experience over many years. I recommend them for disability insurance claims without reservation. 

Don (Florida)

I called this firm a few months ago completely disparaged due to a company cutting off disability benefits at a time that nearly caused me to lose everything.

Attorney Alex Palmera and Danielle worked hard to reach an amicable settlement and my case was settled a few months later. This is a good firm and the specific expertise in disability claims saved me countless hours of hassle at a time when an already fragile state existed.

Thank you Mr. Palamara and Danielle.

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us