Court Orders Principal Life to Pay Long-Term Disability Benefits to Plaintiff

In Craig Robertson v. Principal Life Insurance Company, Plaintiff, a National Account Sales Manager with XPO Logistics in Phoenix, Arizona, became disabled in July 2016 after severely injuring his left foot. His request for short-term disability benefits was granted. In October 2016 he filed a claim for long-term disability (LTD) benefits, but in November 2017, that claim was denied.

Plaintiff argued on administrative appeal that he could not perform the material duties of his own occupation, one of which was to travel and meet face-to-face with clients. Principal countered by saying his job was sedentary and travel was optional, so he was not disabled. After exhausting his administrative remedies, Plaintiff filed this ERISA action. According to the Court, the case raises one main issue: “Whether Principal applied the correct definition of ‘Own Occupation’ under the terms of the policy.”

The U.S. Court for the Northern District of California held in favor of Plaintiff ruling that “the record supports a conclusion that Prudential Life abused its discretion by defining Robertson’s occupation as sedentary and therefore denying his claim. Accordingly, judgment will enter in Robertson’s favor.”

Principal Abused its Discretion in its Interpretation of Policy Language

Robertson contended that his job was not sedentary and travel was required. Principal argued that according to the policy definition of own occupation, it could rely on the Occupational Analysis and Labor Market Survey, which defined the duties of a “National Sales Account Manager” as sedentary.

The Court disagreed and noted that the policy itself states that the Own Occupation is “the one the member is routinely performing when the Disability begins.” As such, Principal could not ignore Plaintiff’s actual job duties at the time of his disability. After careful analysis of the policy language, the Court noted that to ignore the actual job duties of claimants when assessing whether or not they are disabled “defies common sense.” Therefore, Plaintiff’s “actual job requirements must be taken into account” when determining if he is unable to perform the material duties of his own occupation.

Principal Abused its Discretion by “Giving Inadequate Consideration” to Significant Evidence that Plaintiff’s Job was Not Sedentary

In his claim for LTD benefits, Plaintiff stated that, among other things, his job required him to travel 4-6 days a month. His supervisor said that was not required and he could do his job at the home office. The supervisor said that Plaintiff was “permitted to travel” because of his experience and the relationships he had in California, but that traveling for the job was optional.

Contrary to the report of the supervisor, the Director of Human Relations of Plaintiff’s employer sent Principal numerous communications verifying that Plaintiff’s job description listed, “Must be able to travel within assigned territory without restriction.” Based on this, and other supporting evidence, the Court concluded principal abused its discretion in determining Plaintiff could perform the duties of his sedentary job and that travel was optional. “Accordingly, Robertson is disabled under the terms of the policy at issue and is entitled to benefits.”

This case was not handled by our office, but we believe it can be instructive for those who are dealing with insurance companies who are categorizing their job descriptions incorrectly. For questions about this case, or any aspect of your disability claim, contact one of our disability attorneys at Dell & Schaefer.

Leave a comment or ask us a question

Questions About Hiring Us

Do you help Principal claimants nationwide?

We represent Principal clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Principal disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Principal. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Principal.

How do you help Principal claimants?

Our lawyers help individuals that have either purchased a Principal long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Principal:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

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.

Dell & Schaefer Client Reviews   *****

Aziz O.

Cesar Gavidia and Michal Mizrahi, are undeniably one of the most efficient and productive teams of legal experts out there. Professional, ethical, patient and relentless in the pursuit of practical and just results for their clients. Definitely recommend them both to anyone seeking legal council.

***** 5 stars based on 202 reviews

Speak With An Attorney Now

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