In Arlene J Vs. Standard Insurance Company, The Plaintiff has filed this lawsuit against Standard Insurance Company (Standard) in the United States District Pennsylvania for the wrongful denial of short term and long term disability benefits as provided under the disability insurance policy provided by Plaintiff’s employer, Klasko, Rulon, Stock & Seltzer.

History of Plaintiff and Reasons for Submittal of Claim

Plaintiff suffered from several serious medical conditions, including chronic fatigue syndrome, overall sleep apnea and hyponea, arthritis, fibromyalgia and esophageal motility disorder with symptoms including memory impairment, insomnia, and fatigue. Plaintiff also dealt with increased headaches, neck, back, and knee pain, weakness in her arms, muscle twitching, diarrhea, and other gastrointestinal problems and irritability.

Plaintiff became totally disabled on June 29, 2007 because of the aforementioned conditions and filed an application for short term disability benefit payments.

Standard Denies Plaintiff of Short Term Disability Benefit Payments

On or about October 25, 2007, Standard denies Plaintiff’s claim for short term disability benefit payments, claiming that the medical findings did not validate the Plaintiff’s claim of a disability.

Plaintiff appealed this decision. However, on or about December 31, 2008, Standard rejected the Plaintiff’s appeal, again citing that the medical evidence did not back Plaintiff’s claim that she was disabled. On or about September 10, 2010, the Administrative Review Unit of Standard completed its review of the Decision and determined that its previous decision was the correct decision in its view.

Plaintiff’s condition has not changed, and as a result, has not been able to work in a profession in which she is reasonably qualified by education, training, or experience from June 29, 2007 to the present and continuing. Plaintiff has also received Social Security Disability benefits based upon the Plaintiff’s disability commencing June 29, 2007. She still receives Social Security Disability payments as of the current date. (Does being awarded disability benefits from the Social Security Administration mean your disability insurance company must do so as well?)

Due to exhausting her administrative remedies, a lawsuit against Standard was filed by the Plaintiff.

Basis of the Lawsuit Against Standard

Plaintiff claims that Standard did not properly consider the opinions of the Plaintiff’s treating physicians in making its determination of her claim. Standard arbitrarily and capriciously denied the claim as it did not follow the terms of the Plan, denying the Plaintiff of her rightful benefits under the terms of that Plan.

Relief Sought From Standard

Therefore, Plaintiff seeks the following relief from Standard:

  • Judgment against Standard that accounts for all short term and long term benefits due and owing, along with accrued interest
  • All reasonable attorney’s fees and costs
  • All other relief that the Court deems to be fair and just

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