Disability battle against Verizon and Broadspire long-term disability plan lingers in courts for years

Lisa Pakovich and her former employer’s long-term disability plan had been in and out of court for almost five years when Judge Michael Reagan listened to arguments between Pakovich’s disability attorneys and Verizon Long-term Disability Plan on March 24, 2010. It was the third time he had considered this case in less than a year. He’s not the first judge to consider Pakovich’s claim. Three U.S. Court of Appeals, Seventh Circuit judges heard arguments in Pakovich v. Broadspire Services, Inc., 535 F. 3d 601 in April 2008. The decision rendered on July 25, 2008 has been cited in a number of decisions that have involved disability insurance claims since then.

The matter before Judge Reagan this time was which side’s motion for summary judgment should be granted by the Court. In order to prepare a fair memorandum and order, a review of the history of Pakovich’s claim, while redundant to the Judge, remained important to a decision that could stand as a separate document.

Pakovich’s disability attorney filed the first lawsuit against Broadspire Services/Verizon Long-term Disability Plan (Verizon) on her behalf on June 22, 2005. Broadspire had determined that she no longer qualified for long-term disability benefits under the “own occupation” clause of the long-term disability plan. The Court found that Broadspire had wrongfully terminated her benefits because she was unable to perform the essential duties of her sales position with Verizon Wireless, her “own occupation.” Broadspire was ordered to pay the remaining disability benefits for the 24 months of “own occupation” coverage.

But the Court found that Pakovich did not qualify for long-term disability benefits under the “any occupation” terms of the Plan. Broadspire was granted summary judgment on the “any occupation” claim. Pakovich’s disability attorney filed an appeal.

Because Pakovich had not been evaluated under the “any occupation” provision of the policy, the Court of Appeals ordered the District Court to vacate its grant of summary judgment for Broadspire and send Pakovich’s claim back to the disability insurance plan for reconsideration under the “any occupation” provision of the Plan. This was done on September 4, 2008.

From July 24, 2008, when the Court ordered the Plan to review her claim, through January 30, 2009, Pakovich contends that the Plan never communicated with her. On November 10, 2008, her physician, Dr. Lawrence Harmon, delivered a report of his findings during a July 13, 2008 examination which he claimed continued to inhibit her from gainful employment of any kind through to the present.

Seven months had passed by January 30, 2009, the date Pakovich’s disability attorney filed an instant lawsuit under the Employee Retirement Income Security Act (ERISA) provision U.S.C. § 1132(a)(1)B).The disability attorney argued that the Plan’s failure to make a decision within seven months constituted a “deemed denial.” The attorney claimed this “deemed denial” robbed his client of the long-term disability benefits that were rightfully hers from July 2004 to the present. The disability attorney asked that the Court order the Plan to pay his client the unpaid benefits plus interest and cost of living adjustments. He claimed that as of July 2004, Pakovich’s minimum monthly benefit payments should have been $720.20.

In response, Verizon filed a motion to dismiss Pakovich’s claim, because it claimed that the Court did not have subject matter jurisdiction any longer. Verizon had paid Pakovich’s the full benefits demanded by her disability attorney about a month after she filed action. The disability insurance company claimed that her disability attorneys had “jumped the gun.” Verizon argued that there was nothing left for the Court to decide, thus no jurisdiction.

Pakovich’s disability attorney argued that the Court must become involved because if disability insurance companies discover that they can avoid paying benefits, but agree to pay those benefits after a suit has been filed in Court in order to remove Court jurisdiction over the matter, insurance companies could use this as a means for avoiding the payment of the claimant’s attorneys fees.

The disability attorney also argued that the fact that Verizon alleged to have settled Pakovich’s entire claim against the long-term disability plan did not in fact secure all the rights pertaining to her. Under the U.S. Constitution, Pakovich’s case was an actual, ongoing controversy. She had a right to summary judgment in her favor. Without this, what assurance would Pakovich have that the disability insurance company would not change its decision and withdraw benefits?

She had already spent close to five years seeking benefits which the insurance company now admitted it owed her. This had cost considerable fees and costs since November 2006. As the prevailing party, Pakovich could be entitled to attorney’s fees and costs. The disability attorney urged that meaningful relief still existed that would be denied his client if the Court ruled that Pakovich’s claim no longer had legal significance because the matter has already been settled.

In response, Verizon argued that Pakovich’s disability attorney was desperate. No controversy remained between the two parties. Verizon had agreed that it had owed Pakovich the money she sought during her Appeal. Indeed, the disability insurance Plan had already settled the matter and was paying her long-term disability benefits of $720.20 a month as requested in her complaint.

The Court determined that the law stood on Pakovich’s side in this matter. The existence of meaningful relief was all that the Court needed to determine that the motion before the Court for summary judgment would have some effect in the real world. The Court recognized that Pakovich had indeed spent five years seeking to recover benefits wrongfully denied her. If the Court failed to determine whether judgment should be given in her favor, she would have no mechanism in place to maintain her right to benefits. If she had to take the disability insurance company to court again, she could find herself wading through another 18 months of litigation.

On July 29, 2009, the Court denied Verizon’s motion to dismiss Pakovich’s suit. Verizon Plan then filed a cross motion for summary judgment in its favor. When a motion is filed, the Court must look at the evidence in the light that is most favorable to the person being moved against. If cross motions are filed, the Court has to carefully consider the burden of proof each side would have to present to prevail.

On March 24, 2010, Verizon raised the same objections to issuing summary judgment for Pakovich as it had for dismissing her claim as “moot.” The Court had already determined that meaningful relief could be available to Pakovich, so the claim had merit. Now, her disability attorney rightly pointed out that if the Court endorsed the result sought by the Verizon Plan, it would leave her without the power to find representation if the Plan later reversed its decision to pay benefits.

The Court rejected the Plan’s arguments against Pakovich’s motion for summary judgment. They had already been heard and rejected before. The Court granted Pakovich’s motion for summary judgment, concluding that Pakovich was currently disabled under the Plan’s definition of “any occupation” at the time the decision was rendered, making her the prevailing party in the suit. The Court ordered Verizon Long-term Disability Plan to pay her disability benefits of $720.00 by the first day of each month until she either reaches 65 years of age, or until based upon the terms of the Plan, Verizon finds that she no longer qualifies for benefits.

The Court chose to rule on Pakovich’s motions for attorney’s fees as a separate matter. The order on that matter will be discussed in another article.

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

There are 2 comments

  • I agree with Kimberly R, as I am now in a similar boat.

    ChrisOct 27, 2013  #2

  • Broadspire is full of unprofessional and clueless, mean spirited employees. My image of them is of a spoiled child sitting on the floor, clutching his piggy bank and pouting and throwing a temper tantrum. The judge in my friend’s WC case ORDERED them to pay 6 months of back TTD, plus current TTD within 10 days of his 3rd surgery, and they have still not paid him. Their attorney refuses to return any calls, and the paralegal in my friend’s attorney’s office has had to threaten referring the defense attorney to the State Bar Association for disciplinary action. This has been going on for over 3 years, and they have missed countless court dates unless they think they can settle for a mere pittance. They are greedy corporate whores, and fully intend to never pay anyone if at all possible. Yes, they are a business, but they take money grubbing whores to a new level. They are unprofessional, unethical and disreputable.

    Kimberly R.Apr 27, 2011  #1

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.

Sandra B. (Arkansas)

I have nothing but good things to say about how my buyout was handled with my disability claim. The level of professionalism was amazing. All of my questions and concerns were answered either by Danielle L. or Alex P. in such a timely manner and with such care I would recommend them in a heartbeat to anyone needing to approach their provider with buyout options.

They did a fantastic job communicating between the provider and me, always keeping my best interest at heart and always answering my many many questions. They really did take most of the stress out of this whole situation. I would give them a 10 out of 10 for every step of this crazy journey. Thank you so much for helping me through this.

Brenda R. (New York)

I needed assistance with an appeal for a LTD claim that was initially denied. Stephen understood what needed to happen to win the appeal and he did win the appeal for me.

Michael C. (Virginia)

Greg Dell and his assistant Anneli have been extremely responsive and helpful, not only our initial consultations, but in follow-ups 1 and 2 years later with the insurance company to ensure that they comply with their agreements (which they did), as well as a separate and only slightly-related inquiry about our health insurance. I always hear back from them very quickly, which is rare and greatly appreciated.

Speak With An Attorney Now

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