Prudential denies disability benefits to KPMG employee suffering from “sick sinus” syndrome

A disability attorney was forced to file a federal ERISA lawsuit against The Prudential Insurance Company of America after his client was wrongfully denied continued long-term disability benefits.

The Facts of the Case Against The Prudential Insurance Company Of America

Plaintiff was employed by KPMG and was covered under the Long-Term Disability Plan that was provided by Prudential.

Plaintiff became disabled on September 15, 2005 because of “sick sinus” syndrome, where the sinus node, the heart’s natural pacemaker, does not function properly. This syndrome caused the Plaintiff to experience several falls and a motor vehicle accident.

Plaintiff has a pacemaker installed on October 20, 2005 to regulate the rhythm of his heart.

On or about February 28, 2006, Plaintiff files a claim for LTD benefits under the Plan.

On or about September 14, 2006, Prudential approved the claim, beginning on September 15, 2006. Plaintiff receives LTD benefits based upon his psychiatric condition only.

Denial of Prudential’s Disability Benefits Claim

On or about September 4, 2008, Prudential terminated LTD benefits beginning on September 15, 2008, based on the Plan’s 24-month mental illness benefit limitation provision.

On or about July 13, 2009, Plaintiff appealed Prudential’s termination of LTD benefits.

On or about October 7,2009, Prudential denied Plaintiff’s appeal and upheld its decision to terminate Plaintiff’s LTD benefits.

On or about June 4, 2010, Plaintiff appealed original denial and Prudential’s subsequent denial from October 7, 2009.

On or about August 19, 2010, Prudential again denied Plaintiff’s appeal and upheld its decision to terminate Plaintiff’s LTD benefits.

Plaintiff has exhausted all administrative remedies, leading to him filing this lawsuit.

Disability Lawyer Files Lawsuit Against Prudential

According to this lawsuit, Plaintiff claims that Prudential did the following to him:

Relief Sought By Plaintiff In The Prudential Lawsuit

As a result of Prudential’s actions, Plaintiff seeks the following from the Court:

Videos, Questions, Resolved Cases, Lawsuit Summaries & Company Reviews

disability insurance companies complaints

Leave a comment or ask us a question


Do you help Prudential claimants nationwide?

We represent Prudential 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 Prudential disability insurance policy?

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

How do you help Prudential claimants?

Our lawyers help individuals that have either purchased a Prudential 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 Prudential:

  • 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, 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.

How can I contact you?

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.

Dell & Schaefer Client Reviews   *****

Tracy W.

I contacted the law firm of Dell & Schaefer just to check and see if there was a possibility to settle my claim with UNUM and get a lump sum buyout. BEST decision I have ever made! Cesar called me within 24 hours of me sending a email and he discussed my claim in detail with me. Let me tell you, he not only discussed my claim detail but discussed my future plans and diagnosis, he wanted to make sure the settlement was the right option for my case. We decided to move forward with an offer to Unum for the buyout and within three weeks we had an offer. The offer that Cesar negotiated was not only fair but much more than I expected. And the best thing of all, I no longer have to deal with those monthly phone calls and interviews and having someone harass my doctors.

I do not want to forget Mr. Gavidia’s assistant, Anneli Decardenas. She kept me up to date on every aspect of the case, no I did not have to call to get information, Anneli kept me informed. If I did send in a request for information I received a prompt response. Best law firm I have ever had the pleasure to have represent me. Last but not least, I did crunch the numbers and accessed my long term payments against the settlement offer, I can tell you my outcome was very fair.

Read 424 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us