A California disability attorney and his client filed suit against The Prudential Insurance Company of America (Prudential) in the United States District Court Central District of California on October 28, 2011 for unpaid long term disability payments due per the terms of an employee disability insurance plan.
Lorraine A., a former Sony Pictures Entertainment Inc. question writer for the television game production Jeopardy succumbed to Multiple Sclerosis and stopped working for the company in July of 2006. At the time of her departure from work, Lorraine’s health was deteriorating as a result of her illness and she was unable to perform “the material duties of her occupation.” In fact, her cognitive abilities were so affected that “she was unaware of her right or ability to make a claim for benefits under the Sony LTD Plan” at the time of her departure from its employ.
Prudential claimant files for disability benefits after succumbing to multiple sclerosis
In May 2010, Lorraine “became aware of her right” to make a disability claim on her Sony disability insurance policy and did so, but was denied her claim on July 22, 2010. Her appeal to the insurer was denied by Prudential on March 18, 2011. On October 19, 2011 Lorraine submitted a second voluntary request for reconsideration of her denied claim. Despite overwhelming evidence that she qualifies for long term disability benefits through her employee insurance policy, Lorraine’s request for reconsideration was denied. Consequently, Lorraine has now exhausted all pre-litigation solutions and has hired a disability attorney to present her claim to the District Court of Central California for the rendering of a decision in the matter.
Prudential allegedly is in violation of ERISA and breached its contract with claimant
According to Lorraine’s attorney, Prudential breached its contract with Lorraine and violated the Employee Retirement Insurance Security Act of 1974 ERISA) by:
- Failing to pay long term disability benefits to Lorraine;
- Failing to adequately and properly evaluate the merits of Lorraine’s claim; and
- Other acts or omissions.
Claiming an unspecified amount of damages sustained in addition to the loss of her disability benefits, Lorraine and her disability attorney look to the California District Court to determine how much to award her in the litigation. Their requests include:
- Payment of Lorraine’s disability benefits per her Prudential plan;
- Declaration that Lorraine is entitled to immediate reinstatement of her long term disability plan and all ancillary benefits provided in the plan;
- Remanding of Lorraine’s denial of benefits back to the administrator to re-evaluate her claim and take into consideration all medical documentation verifying her disabled condition;
- Entitlement to attorneys’ fees and court costs;
- Pre-interest on unpaid disability benefits; and
- Other relief the Court “deems just and proper.”