Occupational therapist Ernesto R. Campos has filed a lawsuit naming Reliance Standard Life Insurance Company, Rehab America, Inc., Group Long-Term Disability Insurance Plan and Rehab America, Inc. as the defendants. Campos and his disability lawyer filed his complaint in the Western District of Tennessee Eastern Divisional Office at Jackson concerning a disability insurance plan under ERISA. Campos’s complaint states that he and his disability attorney believe that Reliance, as the entity that decides on benefits claims, is “under a perpetual conflict of interest” because they fund his disability insurance plan and also decide if he qualifies as a disability benefits recipient as well. He purports that as the decision maker and the fund provider of his plan, Reliance “allowed its concern over its funds to influence its decision-making” and has taken advantage of “the potential applicability of ERISA to claims.
Background Of Campos’s Disability Claim
Ernesto R. Campos was employed by Rehab America, Inc. as an occupational therapist, and as such, he was covered under his employer’s Reliance Insurance Plan. While under the coverage of the Plan, Campos became disabled and remains so per the specifications of his plan. Campos provided Reliance with all the required documentation proving his status as permanently disabled to no avail. Reliance has, so far, denied all of Campos’s requests for disability benefits.
Initially, Reliance did supply Campos with benefits, but later denied his claim. Consequently, Campos proceeded to appeal the decision of Reliance through the insurance provider’s ERISA appeal process and administrative procedures. Now, after exhausting all his options to solve his disability benefits dilemma, Campos has found himself in a situation where only legal action will prevail. On March 30, 2011, Campos and his Tennessee disability attorney filed a lawsuit and asked for the following remedies from the District Court.
- Damages equal to the amount of disability benefits he was entitled to collect through the date of judgment for the unpaid benefits he has been previously denied.
- Both post- and pre-judgment interest
- A Court Order that requires Reliance to continuing paying Campos’s disability benefits for as long as he qualifies as disabled under the terms of his insurance plan
- A Court Order for the plan administrator to grant Campos disability benefits under any other employee benefit plan he participates in and qualifies for
- Reasonable attorney fees for the employment of his disability attorney
- Any other relief that the Court thinks is proper and just.