Mechanic Loses Claim For Benefits Against Reliance Standard After Employer Makes Oral Misrepresentations Concerning Disability Insurance Coverage
Generally, when employees have a question concerning their employer provided group long-term disability insurance coverage, the first place they turn is to their HR department. HR Departments are not in the business of underwriting, or interpreting insurance policies, and often do not have the adequate knowledge to competently answer specific questions concerning the terms and conditions of the disability insurance plan. They can, and should provide the employees with the long-term disability plan documents, and enrollment information, but beyond those tasks, should not be relied upon to answer questions concerning eligibility and coverage. It is important to know that, although the employer may be liable to its employee, as a fiduciary, misrepresentations made by an HR representative concerning plan coverage will not trump the terms and conditions of the long-term disability plan itself, and no liability will be placed on the long-term disability insurance company.
Employer Misrepresents Coverage Provided Through Group Long-term Disability Insurance Plan
Recently, the U.S. District Court for North Carolina, dismissed an action brought by a former maintenance mechanic against Reliance Standard Life Insurance Company, and his employer, US Cotton, for benefits which he claimed were owed under the his employer provided group long-term disability insurance plan.
Robert Breyan was diagnosed with chronic obstructive pulmonary disorder (COPD), a degenerative lung condition that impedes the ability to breathe. Mr. Breyan was advised by his doctors that he should maintain all of the disability insurance available to him, as his condition was not expected to improve, and that he would likely, one day, need to file a disability claim. Mr. Breyan maintained a private disability insurance policy, and also purchased coverage through the Reliance Standard long-term disability insurance plan, offered through US Cotton. On multiple occasions, Mr. Breyan was misinformed and assured by human resources at US Cotton that the Reliance Standard plan would provide him with 60% of his annual income. They failed to inform him of any possible reductions or offsets for other disability income benefits, such as Social Security disability, nor did they provide him with a summary plan description, describing the terms of the plan.
Due to his COPD, Mr. Breyan was eventually forced to file a long-term disability claim with Reliance Standard. Mr. Breyan’s claim with Reliance Standard was quickly approved, and shortly thereafter, he was approved for social security disability benefits as well. Mr. Breyan then learned that Reliance Standard had overpaid his claim, due to his receipt of social security disability benefits, and that it was reducing his monthly benefits by the monthly amount he was receiving from social security disability.
Mr. Breyan sued both Reliance Standard and his employer for wrongfully denying his disability benefits. Specifically, he claimed that he was due the amount that the human resources employees informed him he would receive, sixty percent of his salary until retirement age – without being reduced or offset by receipt of any other disability income benefits.
The U.S. District Court found that, although US Cotton induced Mr. Breyan to believe that the benefits he would receive would not be reduced or offset by other payments such as social security disability benefits, the law is clear, the plan documents rule. The court found that the oral representations, or misrepresentations, were immaterial as to the question of whether the benefits promised under the terms of the plan were denied.
Although the court dismissed the claim for wrongful denial of benefits against Reliance Standard, it allowed Mr. Breyan to maintain a claim against him employer, US Cotton, for breach of fiduciary duty. The court found that it is plausible for Mr. Breyan to show that US Cotton breached its fiduciary duty to him by not just misinforming him, but also by failing to comply with its affirmative duty to inform when it knew that silence might be harmful.
You can read about more cases with Reliance Standard on this page.
Resources to Help You Win Disability Benefits
Submit a Strong Reliance Standard Appeal Package
We work with you, your doctors, and other experts to submit a very strong Reliance Standard appeal.
Sue Reliance Standard
We have filed thousands of disability denial lawsuits in federal Courts nationwide against Reliance Standard.
Get Your Reliance Standard Disability Application Approved
Prevent a Reliance Standard Disability Benefit Denial
Negotiate a Reliance Standard Lump-Sum Settlement
Our goal is to negotiate the highest possible buyout of your long-term disability policy.
Policy Holder Rating
Short Term Disability Claim/Inconsistent to NO Communication
Staff Lie
Reply
Reliance Standard denied my LTD benefits because COVID-19 limited my ability to provide proof of continued disability.
Reply
Reliance Standard cut off my LTD benefits claiming I'm fit enough to work even though I'm more sick than before.
Reply
Reliance Standard notified me that my benefits were being stopped with no warning or reason.
Reply
I was receiving LTD from Reliance Standard due to breast cancer until they suddenly denied me my benefits.
Reply
Reliance Standard never answers or returns my calls, has not provided me my benefits, and falsely claims I never provided necessary paperwork.
Reply
Reliance Standard is unreasonably prolonging the transition from STD to LTD for my boyfriend.
Reply
Q: Are VA disability payments considered “other income” by Reliance Standard?
Q: Denied short term disability and need to file for long term with same insurer
Q: Will Reliance Standard reduce my LTD payments due to my pension benefits or rental income?
Q: Why is Reliance Standard trying to recover payments I was awarded through another company?
Q: Do I have to provide additional proof of my disability that's specifically requested by Reliance Standard?
Q: How do I access a copy of my STD policy with Reliance Standard?
Q: If I'm not receiving the SSDI benefits for my children from Reliance Standard due to custody, should my SSDI benefits increase?
Q: How can Reliance Standard not coordinate with both of my disability insurance policies?
How to Apply for Reliance Standard Disability Benefits & Top 5 Reasons for a Claim Denial
Why Must Your Disability Insurance Lawyer Understand Your Disabling Condition?
Disability Benefit Denial Reason #5 – Your Medical Evidence is Weak
Disability Benefit Denial Reason #4 - Your Doctor Is Misled By the Disability Company
Disability Benefit Denial Reason #3 - Video & Social Media Surveillance
How Do You Fight a Long-Term Disability Denial?
Disability Denial Reason #2 - Change of Disability Definition & Vocational Review
Disability Denial Reason #1 – Paper Review & IME
How does Reliance Standard deny long term disability benefits after paying for three years?
Reliance Standard overturned its previous denial of long term disability benefits for Texas Retail Store Manager
Reliance Standard overturned LTD denial for Tennessee Technology Sales Consultant
Reliance Standard overturns decision to deny long-term disability benefits to Paediatrician with Ovarian Cancer
Reliance Standard reinstates disability benefits to Project Manager
Reliance Standard Reinstates Benefits for Former Employee of Parent Company, Delphi Financial, Following Successful Appeal
Reliance Standard Overturns Denial of Benefits on Appeal After Claiming It Failed to Receive Medical Records
After sending claimant to a psychiatric IME, Reliance Standard realizes its decision to deny benefits was incorrect
Reviews from Our Clients






