Woman sues for wrongful denial of long-term disability claim
A Louisiana woman has filed a lawsuit against the benefits division of her employer as well as an insurance company for cutting off her long-term disability benefits at the beginning of 2013. She is claiming breach of duty and alleging that the denial of her benefits violates ERISA law.
According to the plaintiff, just over a year after she was approved for the LTD insurance, a claim that she filed was wrongfully denied. It was not reported specifically what her disability is or how it occurred. However, according to the suit, she is still disabled.
The woman is seeking a declaratory action to resolve the issue of the denial. She is also asking for retroactive payment of her benefits with interest, compensatory damages and other expenses and fees.
The plaintiff claims in the lawsuit that despite filing an appeal of the denial, she was given no explanation of why the claim was denied. She also says that her medical information was only selectively reviewed and evidence was not considered by those making the decision on her claim. She further contends that because the employer, CMB Homecare Inc., is the insurance carrier as well as the claim adjustor, there is a conflict of interest.
People who are wise enough to get disability insurance, whether through their employer group plan or an individual policy do this so that they can have peace of mind that they will have some income coming in if they are unable to work. When a disability claim is denied, it may seem like you have little or no recourse against a powerful, well-funded company. It’s easy to feel lost in all of the insurance jargon and red tape. However, legal guidance from those experienced in representing victims of wrongful denials can help even the scales of justice.
Source: Louisiana Record, “Employee sues company’s benefits division over long term disability denial,” April. 28, 2015