Disability Insurance Lawsuit Stories

(Group / ERISA Disability Policy) Robert Hulet, a plant operator, stopped working July 28, 2002, due to chronic left shoulder problems, which resulted in several surgeries. Mr. Hulet was covered for long-term disability benefits under a group disability policy issued by Hartford Life and Accident Insurance Company (hereinafter referred to as "Hartford"). Hartford paid Mr. Hulet long-term disability benefits fo...

John Smith, a 60 yr old attorney, stopped working on April 8, 2004 due to major depression and chronic pain. Mr. Smith was covered for short-term disability benefits under a Prudential Group Policy provided by his employer. Between April 8, 2004 and August 30, 2004 Mr. Smith filed for disability benefits on three separate occasions as during this time period he tried to return to work on two separate occasions...

A federal judge Tuesday granted class-action status to a lawsuit that contends Unum Group, the nation's largest disability insurer, schemed to deny or terminate claims of thousands of disabled Americans.Jim Sabourin, a spokesman for the Chattanooga-based company, described the order as "procedural." He said "it has nothing to do with the merits" of the 2003 ...

A Sales Manager filed his long-term disability claim based on his rheumatoid arthritis with Continental Casualty 16 months after leaving his job. A U.S. Court of Appeals ruled that this claim was untimely, and therefore the insurer, Continental Casualty, would not have to pay the claim for rheumatoid arthritis.After stopping work on September 7, 1999, the Sales Manager waited until January 2001 to file a c...

John Casamassina left the communications company that he worked for in December of 1996 and became self-employed. To replace the life insurance provided by his company, his wife contacted United States Life Insurance Company (US Life) in May or June 1997 to obtain more information about a life insurance policy.On August 5, 1997, Mr. Casamassina visited with Dr. Poet, an ear, nose, and throat specialist, be...

A federal appellate court ruled that it was reasonable for The Hartford, to rely on videotape of the client Hartford had made after she filed a claim for long-term disability.The claimant originally worked as a Technical Writer but filed a long-term disability claim, citing Epstein-Barr virus as the cause of her disability, which was approved. Later in the claim, The Hartford took surveillance over a two-d...

A former Event Coordinator for CITGO covered under a group insurance policy by MetLife was denied long-term disability coverage based on the any occupation definition of long-term disability.The Event Coordinator filed a claim for long-term disability with MetLife based on hypertension, memory loss, diabetes neuropathy, and post-traumatic stress disorder. MetLife approved his claim under the own occupation...

Daniel J. Rochow, the former president of Arthur J. Gallagher & Co., was insured under Life Insurance Co. of North America's disability plan. The Sixth Circuit affirmed that a disability insurer's denial of benefits to a former employee who was terminated because his symptoms prevented him from performing his duties was arbitrary and capricious, even though the employee's diagnosis was not made until after...

Pamela A. Ray, an attorney, was insured under a UNUM disability policy. A Denver trial court ruled recently ruled in her favor that working in a large office building was a material duty of a disability claimant's occupation as an attorney specializing in major real estate, oil and gas and mining transactions. The court determined that UNUM Life insurance Company of America's denial of benefits was arbitrary a...

Carolyn Kinser, an employee of Associates First Capital Corporation filed a lawsuit against MetLife for wrongful denial of disability benefits. Ms. Kinser was disabled from her occupation due to bipolar disorder and major depressive order. Ms. Kinser had been under continued care and treatment with the same psychiatrist for more than ten years.MetLife hired an allegedly independent doctor to review Ms. Kin...

Jenny Eberle, an employee of Purdue University, was initially approved for long-term disability benefits by the Prudential Insurance Company of America. Shortly after her claim was approved, a new claims examiner and registered nurse reviewed Ms. Eberle's medical records and decided to terminate her long term benefits in November 2004.In May 2005, Ms. Eberle sued Prudential alleging breach of contract and ...

Carol Shepherd, a fork-lift operator for Daramic, was insured under the company's group disability plan with Reliance Standard Life Insurance Company. In 2004, Ms. Shepherd had an anxiety attack at work and Daramic suspended her and required that she participate in anger management before returning to work. During her suspension, Ms. Shepherd was receiving treatment at Owensboro Medical Health System Outpatien...

Larry Mack claimed that he is totally disabled from his occupation as a marriage and family therapist due to diabetes. He sued his disability insurer, Unum Life Insurance Company, after being denied his claim for long-term disability benefits. Unum argued that Mr. Mack is not entitled to long-term benefits because he did not receive "appropriate care" as required by his policy. Mr. Mack admitted to not seeking...

On March 8, 2007, a California jury found that Prudential Insurance Company of America (hereinafter referred to as "Prudential") wrongfully terminated Ms. Darla Leeper-Johnson's disability insurance benefits. Ms. Johnson was awarded $15,215,000 in damages, which included $315,000 for past economic loss, $400,000 for future economic, $500,000 for past pain and suffering and $14 million in punitive damages.F...

The U.S. District Court for the Southern District of New York remanded to state court for lack of subject matter jurisdiction a case brought by a disability-insured physician against his insurer for breach of contract and misrepresentation. Because the policy extended coverage only to the physician-owner of a medical practice and his partner, and not to their employees, it fell outside the jurisdiction of the ...

Ms. Deborah Donovan, an input shift operator for Eaton Corp, was insured under the company's self-funded group disability plan. Due to degenerative disk disease, chronic back pain and leg pain, Ms. Donovan filed a claim for total disability benefits in 1993.After ten years of receiving disability benefits, Eaton terminated payment after an evaluation conducted by Broadspire Services Inc. Broadspire claimed...

Mr. Mark J. Schwartz, an accountant, was insured under his employer's group disability plan, sponsored by Metropolitan Life Insurance Co. (MetLife), which limits disability benefits for mental illness to 24 months, but to age 65 for a physical disability.After major heart surgery in 1999, Mr. Schwartz was diagnosed with post bypass anxiety syndrome resulting in elevated blood pressure, dizziness and chest ...

Lawrence Levy, M.D., insured under two disability policies with Minnesota Life Insurance Co., became disabled in March 1996 and has been receiving total disability benefits due to osteoarthritis in his right knee. Dr. Levy claims his disability is an "injury" rather than a "sickness" because the osteoarthritis is due to a basketball injury. The policy provides disability benefits to the age of 65 if the disabi...

Robert Clarke, a market sales manager for Allstate Insurance Company, stopped working in 1992 due to lumbar spinal stenosis, claiming he was unable to sit, stand, or walk for more than 10 minutes. Mr. Clarke was insured under his company's group disability plan administered by Metropolitan Life Insurance Co. and was paid total disability benefits as of 1992. After several back fusion surgeries in 1990, 1992, a...

James Linnen, a powerhouse operator for Goodyear, Tire and Rubber Company, was insured under his company's group disability plan issued by Continental Casualty Company. Mr. Linnen began collecting long-term disability benefits for narcolepsy and cataplexy in 2001. In 2004, Hartford Life and Accident Insurance Company purchased Continental and reviewed Mr. Linnen's disability status.After the treating physi...