Federal Court Orders Principal Life Insurance Company to Pay Disability Benefits

In Zorn v. Principal Life Insurance Company, the plaintiff, a member of the National Association of Professional Insurance Agents, obtained insurance provided to the association by Principal Life Insurance Company (PLIC). The policy provided for five years of benefits for those disabled from their own occupation. After that time, the definition of disability changed and insureds were then considered disabled only if they could not perform the tasks of any job “that reasonably fits his or her background and training.”

PLIC made two arguments in its endeavor to prevent Zorn from qualifying for benefits: 1) The ERISA lawsuit was barred by the statute of limitations; and 2) If the lawsuit was not barred, Zorn was still not entitled to benefits. The Georgia court disagreed with PLIC on both issues and ordered it to pay Zorn long term disability benefits.

The Statute of Limitations

The parties agreed there was a three-year statute of limitations according to the insurance contract. The dispute was over the date that the statute began to run. PLIC argued it began to run when it first denied Zorn’s claim in November 2005. Zorn argued the statute was tolled during the pendency of his appeal and therefore, it did not begin to run until August 30, 2007. He filed his lawsuit on November 10, 2009, within the three-year period of time. Therefore, he argued it was timely. The court agreed with Zorn and noted that Eleventh Circuit cases “have determined that limitations periods are tolled until the end of an administrative review process.” The court held that Zorn’s argument was the correct one and, “Thus, the contractual limitation does not bar Zorn’s claim.”

Zorn’s Claim for Benefits

The court carefully analyzed the duties Zorn was required to perform according to his job description and the medical evidence presented to support that he suffered from interstitial cystitis. Interstitial cystitis is also called painful bladder syndrome. The condition makes patients feel like they have to urinate all the time. It is also painful, so they take pain medication that may affect their cognitive functioning.

Despite reports of two treating physicians and one independent medical examiner that Zorn indeed suffered from interstitial cystitis to a degree that he could not work at his job, PLIC relied on one independent medical examiner who opined that Zorn was not disabled. The doctor who gave this report met with Zorn on only one occasion. Additionally, he was not a specialist in Zorn’s illness. According to the court, that doctor’s “lack of expertise in interstitial cystitis makes his opinion even more conspicuous in its solitude as PLIC’s lone expert support.”

In fact, a second independent medical review concluded that Zorn was as disabled as his treating physicians claimed. In addition, the examiner supported the claim that the narcotics, which were his “only source of relief” also made him “incapable of sedentary work.” In addition, two separate employability analyses concluded that Zorn was disabled and could not work at any occupation.

Considering all the medical evidence and occupational analyses, “the Court finds by a preponderance of the evidence that Zorn was disabled within the meaning of the policy. Accordingly, the Court disagrees with and REVERSES the administrative decision.”

This case was not handled by our office, but it may be instructive to those who are dealing with insurers who are trying to dismiss a claim due to a statute of limitations clause or based on the opinion of a sole independent medical examiner. If you have any questions about disability claims, call us. One of our attorneys will provide you a free case evaluation.


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Principal Reviews
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Principal

Sorry, Principal. My residual and renewal commissions aren't "earned"

Reviewed by Ron on August 24th 2020   Verified Policyholder
(CAPS are added by me for emphasis:) I am a self-employed insurance broker working only on commissions. I was disabled due to surgeries and received some income replacemen... read more >
Reply
Sent on August 24th 2020 by Attorney Rachel Alters

Ron: You certainly can challenge Principal’s interpretation of the various provisions at issue through an appeal, if you have not already.

Principal

Principal will do anything not to pay

Reviewed by George on October 7th 2018   Verified Policyholder
Hello, I’m writing this on behalf of my wife. Her vision has degraded to the point that she no longer is able to see a pc screen without extreme headaches within a few m... read more >
Reply
Sent on October 7th 2018 by Attorney Gregory Dell

George, it sounds like your wife is a victim to the very common 24-month denial. It is unfortunate that Principal will not accept the opinions of the numerous doctors w... read more >

Principal

Principal is absolutely ridiculous. I'm in financial harship after not receibing my full pay from work and exhausting my long term sick

Reviewed by Michelle P. on December 19th 2017   Verified Policyholder
I was placed on medical leave after suffering from vertigo and later diagnosed with Meniere’s Disease. I was put on medication. During these episodes of vertigo, I was n... read more >
Reply
Sent on December 19th 2017 by Attorney Stephen Jessup

Michelle, will your ENT complete the applicable Attending Physician’s Statement? The APS will allow the doctor to place all restrictions and limitations he/she is imp... read more >

Principal

Principal owes me 60k

Reviewed by Daniel S. on March 15th 2017   Verified Policyholder
I had a lawyer for my long term disability claim but they wouldn’t sue them for me because the company I worked for sent them a letter saying I didn’t work but 3 hrs a... read more >
Reply
Sent on March 15th 2017 by Attorney Stephen Jessup

Daniel, we would need to see copies off your denial letters and your policy to determine how we may be able to assist you.

Principal

I lost everything when Principal terminated my benefits without calling or emailing me

Reviewed by Ray T. on September 22nd 2016   Verified Policyholder
I went on short term disability August 1st of 2013 I had to get my left thumb total reconstructed. After 6 months of short-term I went on long-term. My company told me I h... read more >
Reply
Sent on September 22nd 2016 by Attorney Stephen Jessup

Ray, have you received a formal denial letter denying the benefit? If the initial denial occurred in October 2015, there are concerns as to time expiring to file an adm... read more >

Principal

I cant but feel I am being starved out and given the runaround.

Reviewed by Christopher on June 7th 2016   Verified Policyholder
I went off of work may 29, 2015, with a blood clot in my leg. I have had vein surgeries in the past to alleviate pain and discomfort, all of which I took vacation on a Fri... read more >
Reply
Sent on June 7th 2016 by Attorney Stephen Jessup

Christopher, I am not sure the reason for the proof of good health- was this from a different department? If the claim is already in appeal review then there would be l... read more >

Principal

Principal owes me 4k

Reviewed by Louann W. on April 28th 2016   Verified Policyholder
Purchased short term disability through my employer with this group. I’ve been out of work since 2/29/16. Haven’t received the first pay. Contract is I’m supposed to... read more >
Reply
Sent on April 28th 2016 by Attorney Stephen Jessup

Louann, if they uphold the denial of your claim on appeal please feel free to contact our office to discuss what your rights/next steps are. Hopefully they will not nee... read more >

Principal

I've never worked with people that are so obviously stalling before. Bunch of crooks

Reviewed by Mike on March 2nd 2016   Verified Policyholder
I have been disabled for over 10 weeks and Principle kept saying the forms incomplete so they needed all the medical records from my doctor, including office notes. After ... read more >
Reply
Sent on March 2nd 2016 by Attorney Rachel Alters

Mike, is this a policy you purchased on your own? From what you’re saying it seems that they are investigating to determine whether or not there are grounds to rescin... read more >

Answered Questions by Our Lawyers
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Q: Can Principal deduct my social security payment from my monthly Principal disability benefit payment?

Answered on March 30th 2023 by Attorney Gregory Dell
A: Does you disability policy say social security retirement is deductible? If it does then they are allowed to d... Read More >

Q: Why did Principal not back me when Social Security did?

Answered on August 21st 2020 by Attorney Alex Palamara
A: Durron, I am sorry to hear that your LTD claim was denied. While there are different standards for approving L... Read More >

Q: What is the difference between time period of the claim while approved and the time period of the claim while denied?

Answered on August 14th 2020 by Attorney Alex Palamara
A: Mark, please gather all the correspondence concerning your claim and please contact us for a free consultation... Read More >

Q: Will Principal harass me if I don't accept their buyout? And, is it standard for a buyout to be lower than the full benefit paid over time?

Answered on July 17th 2018 by Attorney Stephen Jessup
A: Jan, I have not experienced retaliatory actions form Principal for refusing a buyout offer. As to your second ... Read More >

Q: Can Principal's independent physician determine what I can and cannot do?

Answered on April 30th 2019 by Attorney Cesar Gavidia
A: APC, it is difficult to know what they courts would do or how they would weigh the opinion of Principal’s co... Read More >

Q: Do I have to pay Principal back once I receive back pay from SSA?

Answered on October 5th 2017 by Attorney Stephen Jessup
A: Toni, if your policy was an employer provided policy then almost certainly the policy would contain language t... Read More >

Q: Can Principal take away my deceased husband's 3 month survivor benefit? They justified it saying he was eligible for SSDI when he didn't even apply.

Answered on June 1st 2017 by Attorney Stephen Jessup
A: Michele, I am sorry to hear of your loss. We would need to see a copy of the disability policy to determine an... Read More >
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Get Your Disability Application Approved

Our goal is to get your application for disability income benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their "hired gun" doctor.

Through our experience of having helped thousands of disability insurance claimants, our disability insurance lawyers will guide you through the entire application process and give you the best chance to get your disability claim approved the first time.

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If your disability insurance benefits have been wrongfully denied, then our disability insurance lawyers know exactly what it takes to get your disability claim approved. You only get once chance to submit an Appeal, therefore every piece of evidence that will support your disability claim must be included. The goal is to win your disability benefits at the Appeal level, but while preparing your Appeal you must consider how a federal judge will review your disability claim if your benefit denial is upheld.

Preparing a strong disability appeal package is an art that requires you to understand how the courts interpret your disability policy language, ERISA regulations / laws, and how to strategically present evidence in support of your definition of "disability". We encourage you to contact any of our attorneys for a free immediate review of your disability denial.

Sue Your Disability Company

98% of the disability insurance lawsuits filed by our law firm have resulted in either the payment of benefits or a lump-sum settlement agreement. Our disability insurance attorneys have filed ERISA governed and private policy long term disability insurance lawsuits against every major disability insurance company in state and federal courts nationwide and we love fighting for the "little guy" against the multi-billion dollar insurance company giants.

We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.

Prevent A Disability Benefit Denial

Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.

Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.

Negotiate a Lump-Sum Settlement

Let's discuss if a lump-sum settlement or buyout of your disability insurance claim is both available and makes financial sense for you. Our disability insurance lawyers have negotiated more than five-hundred million dollars in disability insurance buyouts and we know how to get you a maximum settlement. A disability insurance company is not required to offer a buyout and not every disability company offers them.

Questions About Hiring Us

Who are Dell Disability Lawyers?

We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.

In more than 98% of our cases, our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.

We offer disability insurance attorney representation nationwide and we welcome you to contact any of our lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 850 videos and regularly provide tips to help protect your disability benefits.

Who do you help?

Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.

Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.

A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.

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 insurance 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 phone, email, fax, or video conferencing sessions. 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 insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers 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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