Prudential breaches disability contract and jury awards claimant $15.2 million in damages

On March 8, 2007, a California jury found that Prudential Insurance Company of America (hereinafter referred to as “Prudential”) wrongfully terminated Ms. Darla Leeper-Johnson’s disability insurance benefits. Ms. Johnson was awarded $15,215,000 in damages, which included $315,000 for past economic loss, $400,000 for future economic, $500,000 for past pain and suffering and $14 million in punitive damages.

Factual background: Ms. Johnson was employed as a lead project manager in design and construction by the University of California at San Francisco with an annual salary of approximately $75,000 month from May 5, 1992 until she was forced to stop working due to disabling illness on May 21, 1995. Ms. Johnson was an employee of the state of California and therefore her disability claim for benefits was exempt from the strict rules of the Employment Retirement Income Security Act (ERISA). Ms. Johnson’s disabling illness was fibromyalgia, chronic fatigue syndrome, systemic lupus, and antiphospholipid antibody syndrome.

Prudential paid total disability benefits to Ms. Johnson from June 5, 1995 until her termination on June 1, 2001. Ms. Johnson’s disability policy provided benefits only if she was disable from “any occupation”. All of Ms. Johnson’s treating physicians advised Prudential that she was and continued to be totally disabled since 1995. In September 2000, Prudential received information that Ms. Johnson had been horseback riding, which Prudential believed to be inconsistent with her medical condition. Based on the new information of horseback riding, Prudential requested updated medical records and on November 22, 2000 sent all of Ms. Johnson’s medical records to an in-house medical doctor for a record review. Then on January 5, 2001, Prudential sent Ms. Johnson to be examined by an internal medicine doctor. Despite the fact that Ms. Johnson was being treated by a rheumatologist, Prudential sent her to a doctor that did not specialize in fibromyalgia. According to Ms. Johnson, the exam lasted 5-10 minutes and the doctor did not perform a trigger point exam, which is required in order to diagnose fibromyalgia.

On January 26, 2001 Prudential sent a letter to Ms. Johnson advising her that based upon a review of her medical records and the recent medical exam that her benefits would be terminated effective June 1, 2001. Prudential advised Ms. Johnson in their denial letter that she did not have any medical restrictions and she is able to return to work in her own occupation or any other occupation. Ms. Johnson submitted two written appeals and both were denied. Subsequent to the denials of both appeals a lawsuit was filed for breach of contract, fraud, breach of the implied covenant of good faith and fair dealing and violation of the unfair competition statue.

This case is very unique because California is one of the only states that allows a claim for bad faith / punitive damages to be argued at the same time as a breach of contract action. In most states the jury must first determine there was a breach of contract and then a subsequent trial takes place to determine any potential punitive damages.

Questions About Hiring Us

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   *****

Mary R.

I first started working with Dell & Schaefer after two failed back surgeries forced me to stop working. I was the major breadwinner of our family and had a very generous compensation package that included long term disability. I was certainly glad to know that I had the long term disability policy to help us during this major change in my family’s life. I was surprised to learn that long term disability means something very different to the insurance company (MetLife) who held my policy. They wanted to place an 18 month restriction on pay out and wash their hands of me. Hardly “long term”.

I hired Dell & Schaefer to fight for me and that they did. They were well schooled in the tactics of insurance companies and they expertly navigated the many barricades the insurance company placed in front of me. They were extremely knowledgeable in all areas of the law and quickly identified a course of action. They were fair and sensitive with my personal concerns and I always felt that I had an advocate on my side. Their experience proved invaluable as they were able to successfully argue my case and win my long term disability case, securing my benefit and my family’s income needs. And they continue to support me, as insurance companies continue to find ways to challenge the validity of your claim even after the initial decision is made in your favor.

Dell & Schaefer handles everything for me. This is an extraordinarily difficult thing I have had to endure. Without this money, I have no idea how my family would have been able to survive. Insurance companies can be brutal on individuals and when one is at their most vulnerable as I was, it is critical to have a knowledgeable and powerful attorney on your side. I like the fact that I don’t have to worry about anything and that everything is handled for me by Dell & Schaefer. I am glad to recommend Dell & Schaefer to anyone who needs a strong advocate on their side.

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