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Disabled Woman Denied Benefits after Her Policy Purchased by Another Insurance Company

A 48 year old woman, disabled for over ten years due to fibromyalgia and chronic fatigue syndrome, was denied continued benefits after her long term disability coverage was purchased by Hartford Insurance Company. She appealed the denial, but the company upheld the denial.

The woman retained David Allen & Associates to file an appeal with the Eastern District Federal Court. Ruling was made by the Honorable Garland E. Burrell, Jr. on April 23, 2008 approving reinstatement of benefits and award of back payments, attorney fees and interest:

"Plaintiff and Defendant filed cross motions under Federal Rule of Civil Procedure ("Rule") 52 for judgment on the administrative record of this Employee Retirement Income Security Act ("ERISA") action. Plaintiff contends Defendant, who administers Plaintiff's long-term disability insurance policy, improperly denied long-term disability benefits. Defendant counters that Plaintiff's medical condition does not render her "totally disabled" and therefore she is not entitled to disability benefits. This Order constitutes the findings of fact and conclusions of law required by Rule 52."

Plaintiff has shown by a preponderance of the evidence that she is entitled to disability benefits since she is "totally disabled" under the Policy. Accordingly,

(1) Plaintiff's Rule 52 motion is granted and Defendant's Rule 52 motion is denied. Judgment on the administrative record shall be entered in favor of Plaintiff. Plaintiff shall recover all benefits to which she was entitled under the Policy from the date such benefits were terminated in November 2005 to the present.

(2) Plaintiff's requests for attorney's fees and prejudgment interest are granted. The rate of prejudgment interest shall be determined individually for each benefit payment according to the average accepted auction price for the last auction of fifty-two week United States Treasury bills settled immediately prior to the date each of her withheld benefit payments became due, pursuant to 28 U.S.C. ยง 1961(a)."

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