A Washington disability attorney recently filed a federal ERISA lawsuit against the Standard Insurance Company after a client was wrongfully denied long term disability benefits.
The Facts of the Case Against Standard Insurance Company
Plaintiff had Long-Term Disability Insurance from Standard prior to 2007, and it was still in full force and effect throughout this ordeal.
Plaintiff worked her last day on July 1, 2007 and claimed LTD benefits on or about March 2008. She provided medical records and other information to Standard to show that she was suffering from various vision disorders.
Denial of Standard Disability Benefits Claim
On July 3, 2008, Standard denied Plaintiff’s claim for long-term disability.
Standard has a procedure to where a person can dispute a denial by having the claim be subjected to an administrative review.
Plaintiff initiated this administrative review process after the July 3, 2008 denial.
Standard agreed to conduct the administrative review of the claim, which also involved a review of the additional information supplied by the Plaintiff.
On February 24, 2009, Plaintiff was notified by letter that Standard had denied her claim.
Plaintiff requested another administrative review of the claim, to which Standard agreed, along with a review of any additional information the Plaintiff supplied to Standard. This letter, sent August 28, 2008, included reviews from the following 3 agencies.
Plaintiff supplied proof that the Washington State Department of Social and Health Services – Division of Vocational Rehabilitation – had found her to be disabled based on her visual impairment.
Plaintiff also supplied proof that the Washington State Department of Services for the Blind declared her to be blind.
The Social Security Administration also declared Plaintiff to be disabled.
Despite these reports, Standard continued to deny Plaintiff’s claim, with its final denial coming in a letter dated February 25, 2011.
Plaintiff has exhausted all administrative remedies, leading to her filing of this lawsuit.
Washington Disability Lawyer Files Lawsuit Against Standard
According to the lawsuit, Plaintiff alleged that Standard committed the following against the Plaintiff:
- Breached long-term disability insurance contract by not following the terms of the Plan.
- Breached long-term disability insurance contract by not providing coverage for Plaintiff’s covered claim.
- Caused Plaintiff to suffer damages.
- Conducted an unreasonable investigation of Plaintiff’s claim in violation of the law.
- Acted unfairly and deceptively in relying on the facially deficient opinions of its own medical reviewers to deny the Plaintiff’s claim.
- Violated the Consumer Protection Act, thereby causing damage to the Plaintiff.
- Failed to act in good faith towards the Plaintiff and her disability claim.
- Failed to give equal consideration to Plaintiff’s interests.
Relief Sought By Plaintiff In Standard Lawsuit
Due to Standard’s actions, Plaintiff requests the following from the Court:
- All damages caused by Standard’s breach of contract.
- All damages caused by Standard’s violation of the Consumer Protection Act, including treble damages and reasonable attorneys’ fees and costs for presenting this lawsuit to the Court.
- All damages caused by Standard’s bad faith dealings.
- All damages caused by Standard’s negligence.
- An award of full benefits under the ERISA plan, including all pre-judgment interest on any monetary award.
- A judgment that Standard shall be responsible for fulfilling and continuing to fulfill Plaintiff’s long-term disability policy.
- Court costs and disbursements.
- Reopen the administrative claims review process for a full and fair evaluation of the Plaintiff’s claims.