Dearborn National/Dearborn Group 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:

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FAQ

Do you help Dearborn Group claimants nationwide?

We represent Dearborn Group 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 Dearborn Group disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Dearborn Group. 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 Dearborn Group.

How do you help Dearborn Group claimants?

Our lawyers help individuals that have either purchased a Dearborn Group 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 Dearborn Group:

  • 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.

Reviews   *****

Michelle (California)

Jay Symonds,

I just wanted to send you a formal Thank You for your time and support.

I hope you received my email that I have been assigned a new case manager. Since I haven’t received a denial letter, I’m assuming I’m back on the yearly audit schedule. If anything changes in the status of my claim, I will contact you to handle my case. Thank you again for the time you gave me. Very Much Appreciated!

Read 424 reviews

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