Man fights long-term disability claim denial in federal court
When workers sign up for long-term disability insurance under their employer-sponsored plan, they believe that they are making a prudent choice for themselves and their families to protect part of their income if they become ill or injured and unable to work. However, collecting benefits when they are needed may be an unexpected struggle.
A former employee of the energy company NiSource, Inc. is currently fighting that company’s long-term care insurance administrator, Prudential Insurance Company of America, in federal court.
According to the suit, Prudential denied the plaintiff benefits even though he provided adequate evidence of his disability. He claims that the denial was capricious and arbitrary.
Although the plaintiff’s Social Security disability claim was originally denied as well, he appealed that decision. A judge determined that he was entitled to Social Security disability benefits. The suit contends that Prudential refused his request to consider the decision of the judge in that case in determining his eligibility for benefits through his employer-sponsored plan.
The plaintiff’s administrative appeal of Prudential’s decision was denied, so he has taken them to court. He is seeking the benefits he says that he is owed according to the terms of his plan. He is also asking for pre-judgment interest.
This story is not as uncommon as one would hope. Insurance companies can find all kinds of ways to deny the payment of disability insurance benefits to people who have faithfully paid their premiums for years. It can be difficult, if not impossible, to do battle with insurance companies. They have experienced and well-funded legal teams. That’s why it may well be necessary to seek the guidance of a disability attorney with experience going up against big insurance companies. Your future financial stability may depend on it.
Source: West Virginia Record, “Man sues insurance company for wrongful denial of benefits,” Kyla Asbury, May. 13, 2015