A Nevada disability attorney recently filed a federal lawsuit in Nevada against Sun Life Assurance Company of Canada (Sun Life) to recover long-term disability benefits. The Plaintiff, Nancy H., worked as a graphic artist and was covered by a group long-term disability insurance policy issued by Sun Life to Plaintiff’s employer, Clark County School District (Clark County) to provide long-term disability income benefit payments.
Case Facts Against Sun Life Assurance Company Of Canada
Plaintiff worked as a graphic artist until January 18, 2010 when she could no longer perform the substantial duties of her own occupation due to neck and back pain that were secondary to a motor vehicle accident that occurred in August 2009.
On or about May 18, 2010, Plaintiff filed a claim for disability benefits with Sun Life, along with an “Attending Physician’s Statement” from Plaintiff’s primary care physician, Monica W., M.D. (Dr. W.). This statement mentioned that Plaintiff had “severe pain, numbness, decreased strength in the left arm and leg” and that Plaintiff could not use her left hand for “firm grasping” and “fine manipulation.”
On June 17, 2010, Sun Life contacted Plaintiff by phone to discuss her medical condition and symptoms. Plaintiff mentioned having trouble concentrating and multitasking, often falling asleep at work due to the pain caused by the injuries she sustained in the traffic accident from August 2009.
On or about July 27, 2010, Sun Life approved Plaintiff’s claim as of May 15, 2010, stating that the documentation the Plaintiff provided supported restrictions and limitations that substantiated the approval of the Plaintiff’s claim.
In September 2010, Sun Life reduced 50% of Plaintiff’s long-term disability benefits due to the fact that Clark County approved Plaintiff’s application for disability retirement.
On or about November 6, 2010, Sun Life conducted video surveillance on Plaintiff.
On or about November 29, 2010, Sun Life requested updated medical records from Plaintiff.
Sun Life Terminates Long-Term Disability Benefits Claim
On March 21, 2011, Sun Life denied further long-term disability benefits for the Plaintiff, claiming that a “consulting Orthopedic Surgeon” and video surveillance showed that Plaintiff was a very active individual and Plaintiff’s medical records did not prevent sedentary capacity.
As a result, Sun Life could not determine whether the physical and mental symptoms reported by the Plaintiff could prevent her from performing her substantial and material duties as a graphic artist. This is the basis of their denial of the Plaintiff’s disability claim.
Due to the exhaustion of all administrative remedies, Plaintiff has filed this lawsuit against Sun Life.
Files Standard Lawsuit Filed By Nevada Disability Attorney
The lawsuit states that Sun Life failed to provide the following to the plaintiff:
- The disability benefits payments under the long-term disability policy she had paid full premiums under
- Not applying the proper “own occupation” definition defined in the Policy when evaluating her disability claim, using the “any occupation” definition that was not specified in the Policy; this is what led to the denial of the Plaintiff’s disability claim
Plaintiff Seeks Following Relief From Sun Life Lawsuit
Due to Sun Life’s actions, Plaintiff wants following relief from the Court:
- Special damages of over $10,000
- General damages of over $10,000
- Punitive damages of over $10,000
- All pre-judgment and post-judgment interest
- All reasonable attorney’s fees and costs
- All other relief that the Court finds to be proper and just