Aetna Life Insurance Company (Aetna) was sued in two Florida District Courts of Florida by two Plaintiffs for violations of the long-term disability benefits provided under the Employee Retirement Income Security Act (ERISA). In the aforementioned cases, just like the countless other lawsuits filed against Aetna, it is claimed that Aetna has illegally denied the Plaintiffs’ claims for long-term disability (LTD) benefits as promised under their respective plans.

Case 1:

In Patricia H. v. Aetna Life Insurance Company (Aetna), the plaintiff filed an ERISA lawsuit through through a Florida disability attorney. The plaintiff was employed as an accounts payable clerk and was insured via Aetna due to Plaintiff’s employer contracting a long-term disability plan with Aetna, making the Plaintiff eligible for long-term disability coverage via that plan.

Plaintiff stopped working on March 29, 2009 due to disability caused by a cardiac condition. She filed a claim for long-term disability benefits, which Aetna approved on August 31, 2009. Aetna then notified Plaintiff via letter on August 13, 2010 that Aetna terminated future long-term disability benefits. This led to the Plaintiff also losing her health insurance coverage provided by her employer. Plaintiff appealed Aetna’s decision on February 14, 2011, but Aetna denied the appeal on June 30, 2011.

Plaintiff has exhausted all administrative remedies, which led to this lawsuit filing. Plaintiff claims that Aetna continues to deny Plaintiff’s claim despite meeting the definition of “Total Disability” as defined by the Policy and having the Social Security Administration approve her application for Social Security Disability Insurance benefits on August 18, 2011.

Case 2:

In David K. v. Aetna Life Insurance Company, Plaintiff was employed by Truly Nolen of America, Inc. (Truly), which contracted with Aetna to provide short-term and long-term disability benefits to its employees. Due to his employment with Truly, Plaintiff was covered by the policy.

Due to coronary artery disease and resulting fatigue, plaintiff quit working on or about April 28, 2007. Plaintiff began receiving short-term disability benefits on or about April 29, 2009 until October 30, 2009.

On or about November 3, 2009, Aetna denied Plaintiff’s short-term and long-term disability benefits, claiming he did not meet the definition of “Total Disability” as defined in the policy. As a result, Aetna has not paid the Plaintiff since October 30, 2009. Aetna upheld its decision to deny the Plaintiff’s claim via letter on or about December 1, 2010. Due to exhausting all administrative remedies, Plaintiff has filed this lawsuit against Aetna.

Lawsuits Filed Seek The Following Relief

In the two aforementioned cases, the Plaintiffs request the following relief from Aetna in their lawsuits:

  • A judgment that all long-term disability insurance payments that are due to them be paid, along with accrued interest
  • A judgment that the Plaintiffs are declared to meet the “Total Disability” definition as defined by their policies, thereby making them eligible to receive all future long-term disability benefits that are due to them as long as they continue to meet the terms of “Total Disability” as defined by their respective plans
  • Full reimbursement of all court costs and attorney fees
  • All other relief that the Court declares to be proper and just