• Reliance Standard Disability Overview of Denials, Appeals, Applications & Lawsuits
  • Reliance Standard Disability Lawsuit and Claim Denial Options with a Disability Lawyer
  • How to File a Reliance Standard Disability Appeal Following a Long Term Disability Benefit Denial
  • Reliance Standard Life Insurance - Disability Benefit Claim Attorneys-Appeals, Lawsuits and Claims
  • Reliance Standard Disability Insurance Claim Denial ERISA Appeal Tips
  • Reliance Standard Denial of Disability Benefits for an Attorney Reversed by Kansas Judge

Reliance Standard makes disability claimant take them to court twice in 5 years

A ruling in U.S. District Court for the Southern District of New York found Reliance Standard Life Insurance Company (“Reliance”) acted in an arbitrary and capricious manner when it denied Elizabeth Diamond long-term disability benefits. Here is her story.

Ms. Diamond worked for Paine Webber as a desktop publisher. Coverage from Reliance through a Group Long Term Disability (LTD) Insurance Policy paid for by her employer was included in her benefits package. Ms. Diamond fell ill and ceased working on September 9, 2000. She first applied for long-term disability benefits in early March of 2001.

She received a letter dated March 26, 2001, instructing her to apply for Social Security disability insurance benefits if she thought that she would be ill for more than 12 months. She followed these instructions and on August 24, 2001, she received a letter from the Social Security administration finding that she was disabled and awarding her benefits accordingly. Two years later, her disability was re-evaluated. Social Security found that her disability was continuing.

Diamond’s attending physician, noted in her file on September 8, 2004, that his diagnosis for her condition was “Bechet’s disease”, with other symptoms being present such as fibromyalgia, hyperlipidemia, hypothyroidism, migraine headaches, metabolic syndrome, depression and gastritis. He noted that diamond suffered from daily debilitating headaches and frequent breakouts the painful sores in both her GI tract and on the outer surface of the body. It should be noted that Bechet’s disease is a chronic disorder that causes inflammation of small blood vessels throughout body. So it’s understandable that her doctor’s notes indicate that there were many days when she was so tired she couldn’t even take a shower or get out of bed. About the same time, another doctor diagnosed Diamond with chronic migraines which did not respond to medication.

Almost a year later, her doctor indicated she only had 20% of her functional abilities. He noted that her symptoms were so severe they troubled her even when she was resting. At the same time, she went to a headache specialist that found that she had intractable migraines and a degree of neurological impairment but still has the ability to carry out “most of the activities of daily living.”

Set against this background, Reliance initially denied benefits to Diamond on June 14, 2002, claiming that she suffered from no physical impairment that would prevent her from performing the duties of her sedentary occupation. Reliance argued that Diamond could perform the material duties of her regular occupation, and thus was not entitled to long-term disability coverage. Diamond appealed and was denied once again.

After she had exhausted her administrative remedies, Diamond filed an action in Federal Court in 2003. Litigation was settled in July of 2004, with Reliance agreeing to pay Diamond disability benefits with interest and attorney’s fees.

But the story wasn’t over yet. After the settlement, Reliance once again denied Long-term disability benefits effective October 8, 2005. Reliance stated that Diamond was capable a performing the duties of her own occupation.

Diamond appealed, pointing to the various diseases her doctors had diagnosed and how the symptoms from these diseases were preventing her from returning to even a part time work schedule. Reliance’s response was to have her file reviewed by a doctor who did not examine her, but evaluated that there was no evidence in her file to suggest that her impairment would prevent her from performing sedentary work. The doctor went on to state that he saw nothing in the file to indicate what might be causing Diamond’s self reported chronic fatigue. Based on this doctor’s review, Reliance refused to reverse their decision to terminate Diamond’s disability payments.

Diamond then filed her second lawsuit against Reliance, claiming that the denial of her appeal and termination of her LTD benefits was arbitrary and capricious. She asked that her LTD benefits be reinstated retroactively and that she be compensated for her attorney fees, costs and prejudgment interest.

When the Court reviewed Diamond’s case, they considered whether Reliance’s decision was “based on a consideration of relevant factors.” And their decision had to be limited to the reasons given by Reliance at the time of the denial. During this process, they observed procedural irregularities that suggested a failure to consider the relevant factors.

In this case, they found that Reliance’s claim to have “lost” Diamond’s file demonstrated procedural irregularities that were unacceptable. The Court also found that Reliance emphasized the findings of a physician who had never seen Diamond over the findings of several physicians who had.

They also found the Reliance had failed to conduct an independent medical evaluation before reversing their position, and reverting to their denial of her first disability claim. In fact, there was no evidence that Reliance had even reviewed the updated information that Diamond had supplied, even though three years had passed since she had filed originally.

The Court also found that Reliance failed to give weight to the fact that Social Security had found Diamond was disabled, not only initially, but after a second review, two years later.

In the light of these facts, the Court issued summary judgment in Diamond’s favor, ordering Reliance to reinstate Diamond’s long-term disability benefits.

Leave a comment or ask us a question

Questions About Hiring Us

Do you help Reliance Standard claimants nationwide?

We represent Reliance Standard 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 Reliance Standard disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Reliance Standard. 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 Reliance Standard.

How do you help Reliance Standard claimants?

Our lawyers help individuals that have either purchased a Reliance Standard 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 Reliance Standard:

  • 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, GoToMeeting.com 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   *****

Sally B. (Tennessee)

It was great. Initial contact upon inquiry was fast. Stephen explained everything and took the time to answer all my questions. Both Danielle and Stephen followed up promptly and we so easy to work with. Both are very personable and got results!

***** 5 stars based on 202 reviews

Speak With An Attorney Now

Request a free legal consultation: Call 800-682-8331 or Email Us