A Minnesota man says that Life Insurance Company of North America canceled his disability insurance in violation of the Employee Retirement Income Security Act of 1974.
The plaintiff, Michael R., alleges that he signed up for disability insurance as a new Albertsons employee. Michael alleges that in March of 2014 he became disabled in accordance with the terms of the plan and continues to be disabled. According to Michael, in September of 2016, the Life Insurance Company of North America canceled his plan and discontinued his benefits from March 2017 onward.
According to the disability insurance lawsuit, Life Insurance Company of North America is regulated by the Employee Retirement Income Security Act (ERISA). “Life Insurance Company of North America’s decision to deny disability benefits was arbitrary, capricious, unreasonable, irrational, wrongful, contrary to the terms of the Plan,” states the lawsuit.
The complaint asserts that although “plaintiff provided Life Insurance Company of North America with substantial medical evidence demonstrating he was eligible for disability benefits” the company denied his claim. Michael alleges that Life Insurance Company of North America was wrong to end his disability insurance for the following reasons:
- The company’s failure to have him examined by an independent physician.
- The company’s reliance on a review of medical records by a medical professional who was financially biased.
- The company medical professional’s opinion was not supported by the evidence in the plaintiff’s medical records.
- The company ignored the conclusions of the plaintiff’s treating physician.
Michael alleges that he has exhausted all appeal options provided under the ERISA statute to dispute the insurance company’s decision regarding his disability insurance. He claims that since his benefits were discontinued in March of 2017, he has continued to suffer damages and now must incur additional attorney fees to recover benefits he is entitled to under the insurance plan.
According to the lawsuit, the Life Insurance Company of North America has a conflict of interest when it comes to the plaintiff’s disability insurance. “Life Insurance Company of North America both funds the Plan and decides whether participants will receive benefits under the Plan.” “Accordingly, Life Insurance Company of North America has a conflict of interest, which must be considered when determining whether its denial of Plaintiff’s benefits was proper.”
Michael alleges that the Life Insurance Company of North America wrongly considered and protected its own interests and assets when it denied the continuation of his disability insurance. He is seeking damages for his lost disability insurance income benefits, along with interest and reimbursement for all expenses and premiums the plaintiff paid for the plan after it was terminated, along with attorneys’ fees.
ERISA AND DISABILITY INSURANCE
The Employee Retirement Income Security Act of 1974 (ERISA) provides protections for individuals’ retirement plans, as well as for disability insurance, life insurance, and health plans. ERISA requires insurance, retirement, and pension providers to meet the following standards;
- Provide information about the plan to participants
- Set minimum standards for participation, vesting, funding, and benefit accrual
- Provide principles of conduct for plan fiduciaries
- Hold plan fiduciaries accountable
- Provide participants the right to file a lawsuit against fiduciaries
Policyholders who have wrongfully denied disability benefits may wish to speak with an ERISA attorney. ERISA is a complex law that is still changing and an attorney can help protect policyholders’ legal rights.
Fill out the form on this page now for a FREE case evaluation by the ERISA attorneys at Bradley/Grombacher.