Recently, three different lawsuits were filed under the Employee Retirement Income Security Act (ERISA) for denial of disability insurance benefits against the Prudential Insurance Company of America (Prudential) at the District Court of the United States. In all three cases filed through the respective plaintiffs’ disability attorney, Prudential was alleged to have wrongfully denied the respective plaintiffs their claim for long term disability (LTD) benefits.
The First Case: New York Disability Lawyer Sues Prudential
In Belinda Dow v Monroe County Federation of Social Workers, the Prudential Insurance Company of America, the plaintiff through a New York disability attorney filed a lawsuit in the District Court for the Western District of New York. The plaintiff was employed as a Child Support Manager for Monroe County. While working for Monroe County, the plaintiff participated in a disability insurance plan provided by Monroe County Federation of Social Workers to its employees. Prudential was the plan administrator for the disability insurance plan.
The plaintiff was terminated from her position at Monroe county on November 16th 2008 due to her medical impairments and for being absent from work and being unable to perform the duties of her position for one continuous year. The plaintiff applied for short term disability benefits and received them. After exhausting her short term disability benefits and continued to be unable to work, the plaintiff applied for LTD benefits with Prudential under the insurance plan provided by Monroe County Federation of Social Workers to its employees.
The plaintiff was determined by Prudential to be totally disabled within the definition of the plan and was granted LTD benefits. The plaintiff was said to be suffering, among other things, Fibromyalgia, generalized pain syndrome, reactive depression, chronic migraines, trigeminal neuralgia, back spasm, chronic diffused pain syndrome, acute sinusitis and Bilateral Carpal Tunnel Syndrome.
Under the plan, the elimination period was 26 weeks from November 16th 2008 to May 17th 2009. However, Prudential failed to commerce payment of LTD benefits to the plaintiff due to its determination on June 23rd 2009 that the medical information received did not support impairment that would had prevented the plaintiff from the performance of material duties of her occupation. The plaintiff appealed twice and was issued a final denial by Prudential on March 25th 2010. In the lawsuit, the plaintiff alleged that Prudential acted unreasonable and abused its discretion by ignoring medical evidences that support the plaintiff’s disability status. This case filed under ERISA but it may be Exempt from ERISA if the employee was employed by a government entity.
The Second Case: South Carolina Disability Lawyer Sues Prudential
In Darren Gilbert v The Prudential Insurance Company of America, the lawsuit was filed at the District Court for the District of South Carolina by a South Carolina disability attorney. The plaintiff in this case was an employee for Tide Point. He was provided with a LTD coverage plan which was fully insured by Prudential. At the same time, Prudential was also the Claims Administrator for the plan. In this case, it was alleged that Prudential in denying the plaintiff’s claim for LTD benefits was not based on a principled and reasoned decision making process but was instead influenced by its inherent conflict of interest as a fiduciary, insurer and claims administrator of the plan.
The Third Case: Pennsylvania Disability Lawyer Sues Prudential
In the case of Dawn M. Gurke v The Prudential Insurance Company of America filed by a Pennsylvania disability attorney at the District Court for the Middle District of Pennsylvania, it was alleged that Prudential’s actions in denying the plaintiff’s claim for LTD benefits was arbitrary, capricious, in bad faith and was in violation of the provisions of ERISA.
Relief Sought in the three Lawsuits against Prudential
In all the above mentioned cases, the relief sought by the plaintiffs from Prudential in their lawsuits comprises of:
- A declaration that the plaintiffs are entitled to LTD benefits under their respective plans;
- Benefits due and not paid inclusive of interest;
- An award of attorney’s fees and costs;
- Any other relief which the court deem appropriate.