Dearborn faces disability denial lawsuit from disabled account clerk of Katz Insurance Group diagnosed with PTSD

Recently, a former account clerk of the Katz Insurance Group filed a lawsuit against the Dearborn National/Dearborn Group through a disability attorney at the District Court for the District of Maryland. In the case of Tosha Pederson v Fort Dearborn Life Insurance Company, the plaintiff alleged that Dearborn National/Dearborn Group had acted arbitrarily and capriciously in its decision to deny the plaintiff’s claim for long term disability (LTD) benefits.

Dearborn National/Dearborn Group Claim Denial History

The plaintiff was formerly employed as an account clerk with the Katz Insurance Group. While working with the Katz Insurance Group, she participated in an employee welfare benefit plan issued by Dearborn National/Dearborn Group. Dearborn was also responsible for administrating the policy and paying out benefits to claimants. Under the plan, the plaintiff is entitled to LTD benefits she fulfilled the definition of total disability under the plan. Under the plan:

Total disability or totally disabled means during the elimination period and the next 24 months you are:

1) Unable to perform each and every duty of your regular occupation on a full time basis because of a disability

  • Caused by sickness or injury
  • That started while you are insured under the policy and

2) After 24 months of benefits have been paid, you will continue to receive payment only if you are unable to perform with reasonable continuity each and every duty of your regular occupation or any other occupation for which you are or become reasonably fitted by training, education, experience, age and physical and mental capacity.”

Due to post traumatic stress disorder, the plaintiff ceased working with the Katz Insurance Group on May 28th 2009. the plaintiff was paid 13 weeks of short term disability benefits between June 17th 2009 and September 16th 2009. Dearborn National/Dearborn Group later initiated a review to determine whether the plaintiff was qualified for LTD benefits. On January 20th 2010, the plaintiff was informed by Dearborn that her claim for LTD benefits was denied.

On July 26th 2010, the plaintiff filed an ERISA appeal to Dearborn National/Dearborn Group’s decision to deny her LTD benefits. The appeal was denied by Dearborn on September 28th 2010. Nevertheless, Dearborn National/Dearborn Group did determine that the plaintiff was entitled to LTD between August 27th 2009 to August 31st 2009.

A second appeal was filed by the plaintiff on November 19th 2010. Dearborn National/Dearborn Group, in response issued its final denial to the plaintiff on December 29th 2010. The denial was based on a conclusion that the medical documentations did not support impairment as of April 20th 2010; the plaintiff was no longer covered under the policy.

The plaintiff argued in the lawsuit that Dearborn National/Dearborn Group did not did not conduct a full and fair review of the plaintiff’s claim for LTD and was acting in bad faith without considering the medical evidence that supported the plaintiff’s disability status. As a result of Dearborn National/Dearborn Group’s actions, the plaintiff sustained damages to the amount of LTD benefits not paid to her.

Relief sought by the Plaintiff

In the lawsuit, the plaintiff is seeking the following relief through the Court:

  • An order to Dearborn National/Dearborn Group to pay the plaintiff all LTD benefits due
  • Granting the plaintiff a monetary judgment against Dearborn National/Dearborn Group for all amount due and owning
  • An award of attorney’s fees and Costs
  • Other relief which the plaintiff is entitled to.

Did you find this helpful?
Unhelpful (0)

Resources to Help You Win Disability Benefits

Disability Benefit Denial Options
Submit a Strong Dearborn Appeal Package

We work with you, your doctors, and other experts to submit a very strong Dearborn appeal.

Learn more

Sue Dearborn

We have filed thousands of disability denial lawsuits in federal Courts nationwide against Dearborn.

Read more

Protect Your Benefits
Get Your Dearborn Disability Application Approved
We help claimants throughout the entire application process.

Learn more

Prevent a Dearborn Disability Benefit Denial
We manage every aspect of your disability claim following claim approval.

Learn more

Negotiate a Dearborn Lump-Sum Settlement

Our goal is to negotiate the highest possible buyout of your long-term disability policy.

Learn more

Answered Questions by Our Lawyers
(0)
Helpful Videos
(861)
Showing 12 of 861 Videos
Disability Benefit Tips
(329)
Showing 8 of 329 Benefit Tips

Dearborn National Disability & Lawsuit Tips

If you've recently submitted a claim for long term disability benefits to Dearborn National, ... Read More >

What Happens if I Sue Dearborn Before They Decide on My Long Term Disability Benefit Appeal?

In Lisa K. Bunner v. Dearborn National Life Insurance Company (Dearborn), Dearborn denied Plaintiff's ... Read More >

Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company

When you're seeking disability benefits under a long term disability policy, your medical rec... Read More >

Disability Benefit Denial Reason #3 - Video & Social Media Surveillance

One thing many long term disability claimants don't know about (or expect) from the claims re... Read More >

How Do You Fight a Long-Term Disability Denial?

Getting a denial letter from your disability insurance company is one of the ultimate insults... Read More >

Disability Denial Reason #2 - Change of Disability Definition & Vocational Review

One of the top reasons for terminating a claimant's long term disability benefits involves th... Read More >

Disability Denial Reason #1 – Paper Review & IME

At Dell Disability Lawyers, we've seen insurance companies give countless reasons to deny lon... Read More >

How to Apply for Reliance Standard Disability Benefits & Top 5 Reasons for a Claim Denial

At Dell & Schaefer we’ve handled hundreds of long term disability insurance claims against Reliance Standard, and have learned a few thi... Read More >
Dell Disability Cases
(369)
Showing 8 of 369 Dell Disability Cases

Engineer With Depression Wins Prudential LTD Appeal

The claimant is a former Senior Technology Services Engineer for Accolade, Inc. who was force... Read More >

New York Life Approves Disability Benefits for School Teacher With Multiple Sclerosis

Our client, a former elementary school teacher suffering from Multiple Sclerosis, contacted our office after New York Life terminated her clai... Read More >

Lincoln Denies Disability Insurance Benefits to 66 Years old Software Developer with Long Covid and MS

Our client came to us after he was denied continued Long Term Disability (LTD) benefits by The Lincoln National Life Insurance Company. Previ... Read More >

Lincoln LTD Denial Reversed for an Occupational Therapist that was Denied Benefits After 24 Months

Our now client came to us after she received a denial letter following her receipt of long term disability b... Read More >

Nurse With Knee and Back Disorder Wins Hartford Disability Appeal

We represent a General Duty Nurse who was denied long term disability benefits as Hartford im... Read More >

Dell Disability Lawyers Win Disability Insurance Appeal Against Prudential for KPMG Employee

Our client, a former Managing Director - Tax Consultant for KPMG contacted our office after h... Read More >

Lawyer Wins 24 Month Mental Nervous Prudential Disability Denial

Our client, a former law partner of a large national law firm, filed for disability with Prud... Read More >

How does Reliance Standard deny long term disability benefits after paying for three years?

A former Payroll Manager for Solairus Aviation, a large Private Jet Charter and Aircraft Mana... Read More >
Disability Lawsuit Stories
(764)
Showing 8 of 764 Lawsuit Stories

Dearborn faces disability denial lawsuit from disabled account clerk of Katz Insurance Group diagnosed with PTSD

Recently, a former account clerk of the Katz Insurance Group filed a lawsuit against the Dearborn National/Dearborn Group through a disabilit... Read More >

Missouri District court must reconsider Dearborn's LTD denial under a de novo standard

A de novo review gives a disability claimant the ability to have the court review their claim denial without any deference to the disability i... Read More >

Dearborn National/Dearborn Group denies long term disability benefits to woman with fibromyalgia and CFS

When Ruth Jobe lost her ERISA disability lawsuit in District Court, she could have decided that there was no hope for recovering the disabilit... Read More >

Unum Wrongfully Terminated Disabled Lawyer’s Disability Claim of Depression and Anxiety Despite Improvement in His Condition

This Unum lawsuit and appeal in federal court is a great victory for all Unum disability claimants. This ca... Read More >

Federal Court Overturns Aetna Denial Of Disability Benefits

In the recent case of Ferrin v. Aetna Life Ins. Co. a federal judge from the Northern District of Illinois determined that Aetna improperly te... Read More >

Court Finds Irregularities in Procter & Gamble Long Term Disability Benefit Denial

In ERISA cases filed in a district court asking for judicial review of a plan administrator's denial of benefits, the court is generally limit... Read More >

Federal Judge Makes Companion Life Insurance Pay Long Term Disability Benefits

Companion Life tried to play games and deny long term disability benefits, but thankfully a New Mexico Federal Judge made them pay disability ... Read More >

NFL Disability Review Board Ignores Evidence of Disability and Appeal Court Reverses Lower Court Decision

In Darren Mickell v. Bert Bell/Pete Rozelle NFL Players Retirement Plan (Plan), Mickell spent nine years in the NFL as a defensive e... Read More >

Reviews from Our Clients

Request a Free Consultation

Our Lawyers Respond Same Day

5 Ways We Help Get Your Benefits Paid

Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

Submit A Strong Appeal Package

If your disability insurance benefits have been wrongfully denied, then our lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our lawyers for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability lawyers have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance lawyers that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our lawyers have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We welcome you to contact any of our attorneys for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 700 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our lawyers help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

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 phone, email, fax, GoToMeeting 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 800-698-9159 or by email. Lawyers 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.