Prudential Insurance pays disability benefits for 12 years to former Prudential employee then denies claim
Robert Bankston worked for Prudential Insurance Company of America from 1988 to December 1997 as an insurance and financial services agent. Mr. Bankston became completely and totally disabled as a result of severe mental illnesses in 1998 which included: bipolar disorder, major depressive disorder, panic disorder with agoraphobia, and obsessive-compulsive disorder.
Prudential paid Mr. Bankston long-term disability benefits beginning in 1998 and lasting through February 1, 2010 when Prudential reversed their decision to pay Mr. Bankston long-term disability benefits. After paying long term disability benefits for 12 years, how could Prudential think that Mr. Bankston was able to return to work? Prudential has the burden of proving that something changed with his medical condition.
Mr. Bankston and his disability lawyer filed a civil complaint against Prudential in United States District Court in the middle district of Georgia in the Macon division regarding Prudential’s decision to deny further long-term disability benefit payments to Mr. Bankston.
Stated in the complaint, Mr. Bankston is not sure which of the two Prudential plans should be paying him his long-term disability benefits. The question is raised, “Does Prudential pay long-term disability benefits according to the Prudential Welfare Benefit Plan or according to the individual policy Mr. Bankston held with Prudential?” Whichever is the case, Mr. Bankston’s state of health fit within the definition of being disabled according to either of the two plans administered by Prudential.
Nevertheless, the fact remains that Prudential decided to terminate Mr. Bankston’s long-term disability benefits on February 1, 2010 because they believed he was no longer disabled.
Consider this: For Mr. Bankston to receive ongoing payment of his long-term disability benefits, he would have to comply with Prudential’s request for periodically providing documentation from his treating physician or other medical professional who was treating Mr. Bankston’s ongoing need to receive long-term disability benefit payments.
Being that Prudential paid disability insurance benefits to Mr. Bankston for approximately 12 years, it appears that Mr. Bankston faithfully complied with the provisions set forth in his long-term disability plan to supply Prudential with the necessary documentation to prove that he is still completely and totally disabled. Yet Prudential decided to terminate his benefits in what appears to be an arbitrary and capricious manner.
Additionally, the Social Security Administration and the Veterans Administration have found Mr. Bankston to be completely and totally disabled. Mr. Bankston continues to receive Social Security income disability benefits. The Veterans Administration has also stated Mr. Bankston’s impairments rendered him unable to work. With these two government agencies offering concurring opinions to Mr. Bankston diagnoses for mental and physical conditions that render him unable to work with any continuity, it can be difficult for the layperson to comprehend how Prudential could terminate Mr. Bankston’s disability benefit payments.
Not only does Mr. Bankston suffer from psychiatric illness, but he also suffers from physical conditions that render him completely and totally disabled. Conditions like chronic fatigue, obstructive sleep apnea, chronic neck and back pain, restless leg syndrome, gastroesophageal reflux disease, and the side effects which are caused by the medication he takes to try and alleviate some of the symptoms for his conditions.
Mr. Bankston alleges that Prudential’s decision to terminate his long-term disability benefits was arbitrary and unreasonable.
Mr. Bankston is asking the court for relief in that he receives long-term disability benefit payments dating back to February 1, 2010 and all maximum allowable interest under the plan long with any attorney’s fees and court fees associated with his lawsuit.