Long Term Disability Law Blog
Sun Life Assurance Company of Canada (Sun Life) was recently served with two lawsuits by two different Plaintiffs for the wrongful denial of disability benefits.
Sun Life Georgia Case
The Plaintiff, Robin B., has filed this lawsuit against Sun Life because her long term disability benefit payments were wrongfully terminated after being initially granted by Sun Life. Plaintiff became ill following an onset of abdominal pain. She sought medical care and attention and was diagnosed as suffering from reactive lymphoid hyperplasia with progressively transformed germinal centers.
This caused her to suffer a “total disability” as defined by the Plan, forcing her to end her employment at CHS – Trinity Hospital of Augusta. On or about October 8, 2010, Plaintiff submitted a timely application to Sun Life for long term disability benefits as provided under the Policy. By letter dated November 10, 2010, Sun Life approved Plaintiff’s long term disability claim and commenced monthly payments of $1,223, effective November 1, 2010.
On or about April 27, 2011, Sun Life ended Plaintiff’s long term disability benefits based on the reason that she no longer met the definition of total disability as set forth in the Policy. Plaintiff filed an appeal of this decision, but Sun Life rejected this appeal for the final time on August 12, 2011. Due to exhausting her administrative remedies, Plaintiff has filed this lawsuit against Sun Life.
Sun Life South Carolina Case
The Plaintiff, Nolan T., filed this lawsuit against Sun Life because he was denied short term disability benefits when he filed for benefits under the terms of the Plan he was eligible for due to his employment at Bellagio Hotel/MGM Resorts International. Plaintiff filed an appeal of this denial, but Sun Life rejected his appeal. Due to exhausting all administrative remedies, Plaintiff was left with no choice but to file this lawsuit against Sun Life.
Reasonings Behind Lawsuits Against Sun Life
The two Plaintiffs have filed their respective lawsuits because, as both issuer of the Policies and the claims administrators, Sun Life had a conflict of interest when it made the determination that the Plaintiffs were no longer disabled and eligible for benefits under the respective Policies.
Sun Life’s termination and rejection of the Plaintiffs’ claims were capricious, made in bad faith, and without substantial justification. The terminations constituted a breach thereof and also a breach of the fiduciary duty owed by Sun Life to the Plaintiffs. Sun Life has illegally failed and refused to pay the Plaintiffs the disability benefits to which they are entitled to under the terms of the Plans, therefore entitling the Plaintiffs to recover damages in the amounts shown by the evidence at their respective trials.
Relief Sought By the Two Plaintiffs
The Plaintiffs respectfully ask the Courts to grant the following relief:
- The reinstatement of Plaintiffs’ disability benefits from the date they were terminated or were to have begun
- The continued payment of those benefits for so long as the Plaintiffs are eligible to receive them under the terms of their respective Plans
- That Plaintiffs’ reasonable attorney fees be paid
- That all associated court costs are paid
- That all other relief granted by the respective Courts is paid by Sun Life