What is Liberty Life Assurance Company of Boston trying to hide in denial of disability benefits?
This disability insurance case against Liberty Life Assurance is an example of the type of fight that a disability insurance company will engage in once a disability lawsuit is filed. It is often surprising that disability insurance companies will claim they are acting fairly, yet when you ask them to provide claims handling information they will aggressively object.
Disability Attorney Sues Liberty Mutual
Antonio Prado filed a lawsuit against Liberty Life Assurance Company of Boston (“Liberty Life”), administrator of the Allied Domecq Spirits and Wine Group Disability Income Policy, in the United States District Court for the Northern District of California. As an employee of Allied Domecq Spirits and Wine (“Allied”), Prado was a qualified participant of his employer’s disability insurance plan with Liberty Life.
Prado was injured on September 2, 2003 while employed and subsequently applied for long-term disability under Allied’s disability plan. Under the plan, claimants receive funds for up to twenty-four months if an injury renders them unable to work in their “own occupation,” and receive payments beyond that time period if they are unable to work in “any occupation” for which they are reasonably qualified.
Liberty denied Prado’s claim and in 2005, Prado filed a disability insurance lawsuit.
Court finds that because Liberty acted both as the plan administrator and the funding source for benefits, it operated under a structural conflict of interest.
The court found that Liberty’s conflict of interest, in addition to other factors, supported its finding that Liberty abused its discretion in denying Prado’s claim. However, despite the courts conclusion that Prado was unable to perform his “own occupation” for the first 24 months of his injury, Liberty Life again denied Prado’s claim, finding insufficient objective evidence of a disability.
Prado brought a second suit alleging three causes of action:
- review of denial of ERISA benefits;
- violation of California Insurance Code Section 10111.2; and
- failure to produce records under 29 U.S.C. § 1332.
Court holds that Plaintiff is entitled to conduct limited discovery into the nature, extent, and effect of Liberty’s conflict of interest on its decision-making process.
During Liberty’s assessment of Prado’s appeal, Prado made several requests for additional information from Liberty to “prepare an appropriate appeal.” Liberty denied Prado’s request arguing Prado was requesting “private, trade secret, proprietary and/or confidential commercial information regarding [Liberty’s] processes, operations, work, or apparatus which has not been made public and may have the effect of causing harm to [Liberty’s] competitive position. A second request by Prado was also denied.
Prado’s requests for additional documents were aimed at obtaining information relevant to show the nature, extent and effect of Liberty’s conflict of interest. The court was not convinced by Liberty’s claims and allowed Prado to conduct a limited discovery into the Liberty’s conflict of interest on its decision-making process.
Plaintiff argues Liberty was obligated to produce certain documents during its claim assessment.
In addition to documents evidencing the effect of Liberty’s conflict of interest, Prado argued that he was entitled to receive certain documents during the claim determination process under Department of Labor regulations. Among the requested documents were: The Long Term Disability Plan and amendments thereto; The insurance policy issued by Liberty Mutual to insure the Plan; All writings which establish that the Plan has complied with 29 C.F.R. § 2560.503(b)(5); etc.
The court concluded that it needed the requested documents and all relevant information to determine if Liberty abused its discretion in denying Prado’s claims and for that reason granted Prado’s requests.
Conclusion
The court granted Prado’s Motion for Order Directing Liberty to Augment the Administrative Record and for Leave to Conduct Discovery.
Generally, claims denials reviewed by a court are limited to the administrative record available to the administrator at the time it rendered its decision when the administrator is found to have been granted discretion to interpret the policy. However, a court may allow limited discovery when it deems appropriate.
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Our goal is to get your application for disability insurance benefits approved. Applying for disability insurance benefits can be a difficult process and the information you provide is critical. Most disability insurance companies look at your application in hopes of finding a reason to deny your claim. Your disability company will ask you to complete numerous forms, interview you, request lots of information, speak with your doctors and possibly request to have you examined by their hired gun doctor.
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We have recovered hundreds of millions of dollars for our clients and we would like the opportunity to provide you with a free review of your disability benefit denial. There are many complex factors in a disability benefit lawsuit and the legal battle to win long term disability benefits can be fierce.
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Approval of long-term disability is a continuous process as every disability insurance company will evaluate your eligibility for benefits on a monthly basis. You can never let your guard down and assume that your disability company will continue to pay your benefits for as long as you think you need them.
Our disability insurance law firm offers a reasonable flat fee monthly claim handling service in which we handle every aspect of your long-term disability claim and do whatever it takes to make sure you are paid every month.
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Who are Dell Disability Lawyers?
We are disability insurance attorneys that know how to get your short or long term disability benefits paid. As a nationwide law firm we have helped thousands of disability insurance claimants throughout the United States to collect hundreds of millions of dollars of disability insurance benefits from every major disability insurance company.
Our attorneys have been able to either get our clients paid monthly disability benefits or obtain a one-time lump-sum settlement in more than 98% of our cases. Our disability insurance lawyers have seen it all when it comes to disability insurance claims and we know exactly what it takes for your disability claim to be approved.
We offer disability insurance attorney representation nationwide and we welcome you to contact any of our LTD lawyers for a free immediate review of your disability claim. We also invite you to visit and subscribe to our YouTube channel where we have more than 900 videos and regularly provide tips to help protect your disability benefits.
Who do you help?
Our disability insurance attorneys help individuals that have either purchased a long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer. We have helped individuals in almost every type of occupation with monthly disability benefit payments ranging from $1,500 to $50,000.
Our clients include all types of employees ranging from retail associates, sales representatives, government employees, police officers, teachers, janitors, nurses, pilots, truck drivers, financial advisors, doctors, dentists, veterinarians, lawyers, consultants, IT professionals, engineers, professional athletes, business owners, and high level executives.
A strong understanding and presentation of the duties of your occupation is essential for securing disability insurance benefits.
Do you work in my state?
Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability insurance lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
What are your fees?
Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.
The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.
In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.
Do I have to come to your office to work with your law firm?
No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via phone, email, fax, or video conferencing sessions. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.
How can I contact you?
When you call us during normal business hours you will immediately speak with a disability insurance attorney. We can be reached at 800-698-9159 or by email. Lawyers and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.