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Pizzeria owner suffering from Celiac disease filed lawsuit against Berkshire Life Insurance Company of America for breach of contract in refusing to pay disability benefits

Recently a lawsuit was filed against the Berkshire life Insurance company of America at the Circuit Court for the County of Wayne in Michigan by an owner and operator of several pizzerias through his disability attorney. The disability lawsuit was filed after Berkshire evaluated the disability claim and made a determination that the claimant was not disabled.

The Facts of the Case:

The plaintiff Patrick Buck purchased an insurance policy on March 15th 1990 with Berkshire Life that included total disability coverage. On April 17th 2008, the plaintiff was diagnosed as suffering from Celiac disease. Celiac disease is a type of disease that affects the small intestine which hinders with absorption of nutrients from food. Individuals who suffer from Celiac disease are not able to tolerate gluten, a vegetable protein that is found in Barley, Rye and Wheat. Symptoms of the disease include:

  • anemia
  • fatigue
  • bone or joint pain
  • arthritis
  • bone loss or osteoporosis
  • depression or anxiety
  • numbness in the hands and feet
  • seizures
  • irregular menstrual periods
  • infertility or recurrent miscarriage
  • sores inside the mouth
  • dermatitis herpetiformis

In addition, individuals affected by celiac disease can also suffer from other diseases in which the immune system attacks the body’s healthy cells and tissues. The connection between celiac disease and these diseases may be genetic. They include

  • Addison’s disease
  • Diabetes (Type 1)
  • Liver disease
  • rheumatoid arthritis
  • Sjorgen’s Syndrome
  • Thyroid disease

Due to his medical conditions, the plaintiff was instructed by his attending physician to avoid contact with all gluten products. The plaintiff informed Berkshire Life in writing of the situation and submitted a disability statement requesting disability income benefit payments as per the terms under the life insurance policy issued by Berkshire Life.

Despite having kept and complied with all the terms, requirements and conditions stipulated in the disability insurance policy, Berkshire Life refused to pay any disability benefits to the plaintiff. Reasonable proof supporting the plaintiff’s claim was also submitted to Berkshire Life. However, even after through many repeated requests for payment, Berkshire Life still refused to make disability income benefits payments to the plaintiff according to the policy.

Relief sought by the Plaintiff under the Lawsuit

In the lawsuit, the plaintiff argued that because of the failure of Berkshire Life to honor its contractual obligations, Berkshire is in breach of the contract between it and the plaintiff. As such the plaintiff is seeking from the Court:

  1. A declaration that Berkshire Life is liable to pay the plaintiff disability income benefits
  2. Judgment against Berkshire Life for compensatory and exemplary damages which the plaintiff is entitled to inclusive of interest, attorney fees and any penalties that are provided by the law
  3. A speedy hearing of this lawsuit
  4. A trial by jury

Notice of Removal:

Berkshire Life on April 19th 2011 in response to the plaintiff’s lawsuit, filed a motion for the case to be removed and heard in the Federal District court for the Eastern District of Michigan instead of State Court. It is not uncommon for a disability insurance company to prefer to have a case in federal court rather than state. Our disability law firm prefers to handle disability lawsuits in federal court.



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