Prudential’s motion to dismiss claimant’s disability benefits is denied

Jenny Eberle, an employee of Purdue University, was initially approved for long-term disability benefits by the Prudential Insurance Company of America. Shortly after her claim was approved, a new claims examiner and registered nurse reviewed Ms. Eberle’s medical records and decided to terminate her long term benefits in November 2004.

In May 2005, Ms. Eberle sued Prudential alleging breach of contract and breach of the covenant of good faith and fair dealing. Prudential filed a summary judgment motion claiming Ms. Eberle failed to provide objective proof of her disability. Ms. Eberle had four treating physicians that stated she was disabled and could not work. Prudential hired two Registered Nurses and one doctor, which opined that Ms. Eberle’s disease did not prevent her from performing her pre-disability occupational duties.

Judge Rudy Lorenzo found that Ms. Eberle satisfied her burden under the policy of providing Prudential with objective medical evidence of her disability but there was a discrepancy as to whether Ms. Eberle’s diabetic complications render her totally disabled from her occupation. The policy defined total disability as “unable to perform all of the material and substantial duties of his or her occupation on an Active Employment basis because of an Injury or Sickness”. Judge Lorenzo found that a “genuine issue of material fact as to whether Ms. Eberle was ‘disabled’ as defined by the policy.” Prudential’s motion for summery judgment was denied.

See Jenny Eberle v. The Prudential Ins. Co. of America, No. 4:05-cv-0030, N.D. Ind., Lafayette Div.; 2007 U.S. Dist..

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