What is Liberty Life Assurance Company of Boston trying to hide in denial of disability benefits?
This disability insurance case against Liberty Life Assurance is an example of the type of fight that a disability insurance company will engage in once a disability lawsuit is filed. It is often surprising that disability insurance companies will claim they are acting fairly, yet when you ask them to provide claims handling information they will aggressively object.
Disability Attorney Sues Liberty Mutual
Antonio Prado filed a lawsuit against Liberty Life Assurance Company of Boston (“Liberty Life”), administrator of the Allied Domecq Spirits and Wine Group Disability Income Policy, in the United States District Court for the Northern District of California. As an employee of Allied Domecq Spirits and Wine (“Allied”), Prado was a qualified participant of his employer’s disability insurance plan with Liberty Life.
Prado was injured on September 2, 2003 while employed and subsequently applied for long-term disability under Allied’s disability plan. Under the plan, claimants receive funds for up to twenty-four months if an injury renders them unable to work in their “own occupation,” and receive payments beyond that time period if they are unable to work in “any occupation” for which they are reasonably qualified.
Liberty denied Prado’s claim and in 2005, Prado filed a disability insurance lawsuit.
Court finds that because Liberty acted both as the plan administrator and the funding source for benefits, it operated under a structural conflict of interest.
The court found that Liberty’s conflict of interest, in addition to other factors, supported its finding that Liberty abused its discretion in denying Prado’s claim. However, despite the courts conclusion that Prado was unable to perform his “own occupation” for the first 24 months of his injury, Liberty Life again denied Prado’s claim, finding insufficient objective evidence of a disability.
Prado brought a second suit alleging three causes of action:
- review of denial of ERISA benefits;
- violation of California Insurance Code Section 10111.2; and
- failure to produce records under 29 U.S.C. § 1332.
Court holds that Plaintiff is entitled to conduct limited discovery into the nature, extent, and effect of Liberty’s conflict of interest on its decision-making process.
During Liberty’s assessment of Prado’s appeal, Prado made several requests for additional information from Liberty to “prepare an appropriate appeal.” Liberty denied Prado’s request arguing Prado was requesting “private, trade secret, proprietary and/or confidential commercial information regarding [Liberty’s] processes, operations, work, or apparatus which has not been made public and may have the effect of causing harm to [Liberty’s] competitive position. A second request by Prado was also denied.
Prado’s requests for additional documents were aimed at obtaining information relevant to show the nature, extent and effect of Liberty’s conflict of interest. The court was not convinced by Liberty’s claims and allowed Prado to conduct a limited discovery into the Liberty’s conflict of interest on its decision-making process.
Plaintiff argues Liberty was obligated to produce certain documents during its claim assessment.
In addition to documents evidencing the effect of Liberty’s conflict of interest, Prado argued that he was entitled to receive certain documents during the claim determination process under Department of Labor regulations. Among the requested documents were: The Long Term Disability Plan and amendments thereto; The insurance policy issued by Liberty Mutual to insure the Plan; All writings which establish that the Plan has complied with 29 C.F.R. § 2560.503(b)(5); etc.
The court concluded that it needed the requested documents and all relevant information to determine if Liberty abused its discretion in denying Prado’s claims and for that reason granted Prado’s requests.
The court granted Prado’s Motion for Order Directing Liberty to Augment the Administrative Record and for Leave to Conduct Discovery.
Generally, claims denials reviewed by a court are limited to the administrative record available to the administrator at the time it rendered its decision when the administrator is found to have been granted discretion to interpret the policy. However, a court may allow limited discovery when it deems appropriate.
Resources to Help You Win Disability Benefits
Get Your Liberty Mutual Disability Application Approved
Prevent a Liberty Mutual Disability Benefit Denial
Negotiate a Liberty Mutual Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Gregory Dell and Stephen Jessup discuss their experience in handling Liberty Mutual claims at all stages
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I’m extremely satisfied with the experience I have had with this firm from day one. The lawyer who has handled my case, Alex, is very efficient and attentive to all my questions and concerns. They are always aware of how my case has gone and they care about my health. I feel optimistic with them because they are very attentive during the process of my claim. I would not hesitate to recommend families and friends if in any situation they need their services. Kathleen as well has been very well and assisted me with this case. I highly appreciate everything they have done for me.
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Without them my LTD company was dropping my plan with me still suffering from my accident, even with doctor’s statements I’m still disabled. The LTD company didn’t want to advance my policy to the next stage of years of pay. Dell Disability Lawyers saved my policy, and helped to enforce the LTD company’s own policy (for its policy holder, me) that I would be covered still under the LTD policy I had paid for at my previous job, when my accident occurred. These lawyers know what they are doing and can help you too. LTD companies will try to drop you when you still need coverage just because they don’t want to pay on your policy anymore. Don’t let them break contract with ya because they are trying to get out of it. Hit em with legal action to ensure the continuation of your policy you paid for. Dell Disability worked very well for me and continue to do so.
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This law firm is the best so far. MetLife denied me two times, they appealed two times for me and they won of course. So if you are on disability and want a chance at winning your case use this firm Dell disability lawyers, kind courteous understanding and they get the job done. You won’t be disappointed.