In 2021, our client from Orlando, FL, suffered from a traumatic brain injury (TBI) and multiple fractures due to a motorcycle accident that nearly killed him. This accident resulted in lasting medical consequences that interfere with his day-to-day life and now prevent him from working in any capacity.
Because of his chronic pain and other debilitating symptoms, our client had to leave his previous occupation as a Chemical Sales and Commercial Manager. Due to the new financial strain caused by his TBI, he also submitted a claim for short-term disability (STD) benefits with Prudential. The insurance provider originally approved STD benefits through November 2, 2021. It also confirmed it would review our client’s request for long-term disability (LTD) benefits since his condition had not improved.
However, Prudential notified our client in September terminating his STD benefits beyond October 31st and denying his LTD claim.
Substantial Medical Reports Demonstrate Our Client’s Disability
Prudential’s irresponsible claim that our client was not eligible for extended STD benefits of LTD ones blatantly ignored all provided medical records from multiple doctors and medical institutions.
Medical imaging that demonstrated our client’s traumatic brain injury and other fractures came from centers such as NeuroSkeletal Imaging, Florida Eye Associates, and Jacksonville Orthopedic Institute.
These medical reports detailed how our client’s symptoms prevent him from fulfilling his duties as a Chemical Sales and Commercial Manager, including:
- Spending 40 percent of his time traveling to multiple states and countries
- Setting and achieving sales targets for the organization through effective planning and budgeting
- Establishing the strategic and tactical plans to manage all customer relations and communications
- Developing joint business development plans with distribution
- Analyzing equipment application and mining techniques, and providing recommendations for the right product solution.
- Engaging in customer or regional opportunities for brand promotion, including trade shows, conferences, and sponsorships
- Supervising seven employees
The medical records also included multiple pictures of the injuries our client sustained after his motorcycle accident.
Prudential Breached Its Fiduciary Duty Owed to Our Client Under ERISA
Under the Employee Retirement Income Security Act of 1974 (ERISA), an insurance company owes the fiduciary duty of acting “solely in the interest of the participants and beneficiaries.” By ignoring overwhelming medical evidence that established our client’s disability, Prudential breached this duty and carelessly disregarded the law and our client’s needs.
Instead of providing the necessary benefits our client was eligible for, Prudential chose self-interest and recklessly terminated STD benefits only two days before the end of the maximum benefit period and denied his LTD claim. This decision is especially absurd and wrongful as the company previously confirmed his eligibility for STD benefits on two separate occasions.
Following Dabdoub Law Firm’s appeal and the submission of additional medical records, Prudential finally did the right thing and approved our client’s LTD benefits for his traumatic brain injury and persistent disability in the fall of 2022.
Help from a Lawyer with Expertise in Disability Insurance
Disability insurance law is complex, which is why hiring an experienced disability attorney is important. Our whole team focuses on disability insurance claims, which gives us the legal expertise you need for your case.
At Dabdoub Law Firm, we have:
- Experience with every major disability insurance company
- A proven track record of success in winning major disability lawsuits
- Recovered millions of dollars in disability benefits for clients
To help you get the help you need, we never charge fees or costs unless you get paid.
Our firm can help at any stage of your disability insurance claim, including:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; or
- Filing a lawsuit against your disability insurance company.
Because federal law applies to most disability insurance claims, our lawyers can represent clients across the country. We have helped clients secure a positive outcome with insurance companies like CIGNA, Paul Revere, Liberty, United of Omaha, LifeMap Assurance Company, and UNUM.
Call Dabdoub Law Firm today at (800) 969-0488 or fill out our online form to speak with an experienced disability attorney. We offer free consultations.
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