An Ohio disability attorney filed a legal action at the District Court for the Southern District of Ohio recently against the Prudential Insurance Company of America (Prudential) for violations of the provisions under the Employee Retirement Income Security Act (ERISA). In Marylee Duvall Vs Prudential Insurance Company of America, the plaintiff Marylee Duvall alleged that Prudential had arbitrarily and capriciously denied her claim for disability benefits by ignoring all the evidence submitted by the plaintiff to support her claim.

The Nature of the Complaint

The plaintiff was employed by NiSource, Inc. as a human relations coordinator in 2008. She participated in a group long term disability benefits policy for NiSource’s employees in which Prudential was the insurer for. The plaintiff stated in the lawsuit due to Prudential being the insurer for the group long term disability benefits policy mentioned, Prudential is the real party in interest with respect to her claim.

Claim for Short Disability Benefits and Denial of Long Term Disability Benefits by Prudential

In July 2009, due to an assemblage of medical symptoms associated with a variant of Parkinson’s disease, the plaintiff stated that she became unable to work. The plaintiff also stated that she made a timely application for short term disability benefits and was approved by Prudential for the full complement of short term disability benefits to which she was entitled. Upon the expiry of her short term disability benefits, the plaintiff filed a timely claim for long term disability benefits with Prudential. However, Prudential denied her claim for long term disability benefits.

Appeals To Prudential’s Denial Of Long Term Disability Benefits

In response to Prudential’s denial of the plaintiff’s claim for long term disability benefits, the plaintiff filed a timely ERISA appeal to Prudential. In support of her appeal, the plaintiff submitted additional evidence. Nevertheless, Prudential rejected her appeal and reaffirmed its prior decision to deny the plaintiff’s claim for long term disability benefits.
A second ERISA appeal was later made by the plaintiff to Prudential with more medical evidence submitted to support her appeal. This second and final appeal by the plaintiff was also denied by Prudential on June 2nd 2011. The plaintiff alleged that Prudential had ignored the evidence that she submitted in support of her claim.

The plaintiff alleged that as a result of Prudential’s arbitrary and capricious actions, she has suffered damages in the form of lost disability benefits.

Relief Sought by the Plaintiff

With the final denial of appeal by Prudential, the plaintiff stated that she have exhausted all her administrative remedies. Hence, the plaintiff is brining this civil action against Prudential under ERISA and seeks an award of long-term disability benefits. The plaintiff is specifically seeking the following relief from the Court:

  • A determination that the plaintiff is disabled under the terms of the Plan and is entitled to long term disability benefits.
  • An order directing Prudential to pay to the plaintiff, in a lump sum, an amount of money equal to the benefits she should have received from the time she became eligible to receive disability benefits from Prudential, through the date of judgment.
  • An order directing Prudential to begin paying to the plaintiff a monthly benefit, beginning on the date of judgment and continuing until the plaintiff is no longer eligible for benefits under the terms of the plan.
  • An award of Pre-judgment and post-judgment interest.
  • An award of Attorney’s fees and the costs of this action.
  • An award of other and further relief as the Court determined to be equitable and just.