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Liberty Life Has a Conflict of Interest and Court Orders Reinstatement of Long-Term Disability Benefits

In Aberg v. Charter Communications, Inc., et. al, plaintiff fell off her horse on two separate occasions. She was seriously injured in the first fall, suffering a compression fracture of her vertebrae among other injuries. Barely a year after the first fall, she was “thrown off” of her horse again. Her treating physician and physical therapist both recorded in their records that the second fall significantly exacerbated her previous injuries. Although she was able to return to work for a short period of time, she had to give up her sedentary job as a customer care billing advisor due to her inability to sit for any length of time. She was awarded short term disability benefits due to her inability to work in her own occupation. When those benefits were exhausted, she was granted long-term disability benefits.

After awarding plaintiff long term disability benefits in November 2014, Liberty informed plaintiff that it did not guarantee payment through the maximum benefit duration. Subsequently, Liberty terminated her benefits. After she exhausted her administrative remedies, Aberg filed this ERISA lawsuit. The federal district Court, after evaluating all the evidence, held that Liberty’s termination of benefits was arbitrary and capricious and ordered it to reinstate plaintiff’s benefits.

Liberty’s Termination of Benefits was Arbitrary and Capricious

The Court found two main reasons that showed the decision terminating benefits was arbitrary and capricious:

1. Liberty had a conflict of interest. In its review, the court kept in mind that Liberty was both the entity charged with determining whether the plaintiff qualified for benefits and the one that would pay out the benefits. “Courts should ‘remain cognizant of the conflict of interest that exists when the administrator has both the discretionary authority to determine eligibility for benefits and the obligation to pay benefits when due.’”

2. Liberty conducted a selective review of the evidence. Liberty had its specialist review Aberg’s medical records. There was no change in the records from the time Liberty granted Aberg benefits until the time it terminated them. The specialist Liberty hired to review the records ignored the parts of the medical record that supported Liberty’s initial grant of plaintiff’s application for benefits and overlooked medical evidence that supported her claim for benefits. The reviewer did not give any reason for discounting the treating physician’s opinion that plaintiff was disabled. When employee benefits plan administrator’s terminate benefits, they have to set forth the reasons in language understandable to the plan participant.

The Remedy is to Order Benefits Reinstated

Relying on precedent, the Court reinstated benefits for the plaintiff, finding that, “Where the plaintiff was actually receiving benefits and those benefits were improperly terminated, the appropriate means to restore the status quo is reinstatement of benefits that were being paid before the improper denial.”

This case was not handled by our office, but we feel it can be instructive to those who had their long term disability benefits terminated when there had been no change in their condition since the benefits were awarded. If you have a question about this, or any other issue concerning disability benefits, contact one of our disability attorneys for a free consultation.

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FAQ

Do you help Liberty Mutual claimants nationwide?

We represent Liberty Mutual 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 Liberty Mutual disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Liberty Mutual. 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 Liberty Mutual.

How do you help Liberty Mutual claimants?

Our lawyers help individuals that have either purchased a Liberty Mutual 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 Liberty Mutual:

  • 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.

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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.

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