Ex-Reporter Prevails In ERISA Suit Against Prudential

@B_V - Your story is an amazing one. My husband and I are both lawyers and we constantly see how insurance companies shirk responsibility and blame patients. Your case and your sharing this information will help others. Kudos to you and your team at Barbara Comerford & Associates. If feels so good to know our medical situation is credible in the legal venue.
 
B_V said:
I'm fortunate that I found a good lawyer willing to take my case on contingency (meaning they don't get paid much unless we win the case) and that I could afford - both in $$$ and in energy - the testing required to prove my disability. The ERISA law is really messed up & tilted heavily in favor of the insurers. There are no jury trials and no punitive damages possible. So if an insurance company acts in bad faith and f*cks people over, the worst thing that can happen for them is having to pay the original benefit. In very rare cases the judge orders the insurance company to pay the plantiff's lawyer's fees, but my judge did not do that. So I'm a little bummed because her opinion is so strong and that is really the only punishment available under the law.
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Congratulations, you kicked their butts :thumbup:

I also had legal assistance but i did not have to take on such a behemoth as you did, and you had some awesome evidence (i only got through a few pages of the judgement so far).

Do be vigilant, can they follow you around and use something you do such as leave the house to cancel your benefits? Around here that does happen regularly :(

It might be nice if your story ends up in a news article that goes viral, they deserve to be outed for their practices.
 
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B_V said:
Not quite no one. A good friend of mine in DC works on disability policy, and has for 20 years, first on Cap Hill for various senators and now with a non-profit. They are trying but it's uphill. Recently some new Dept of Labor regulations for ERISA went into effect that help beneficiaries. I'll see if I can find a write-up somewhere.

Edit: Here is a DOL fact sheet. Major ERISA overhaul is needed but these changes are helpful.
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Tell your friend he’s doing God’s work. I’m pro business, but Erisa promotes what amounts to false insurance,
 
@Diwi9. With ERISA, the insurance company does not need to blame anyone. They can simply not pay, and wait out the claimant. There’s no penalty forvmalfeasance, even if it is obvious that the claimant is fully disabled, the maximum penalty is that the insurance company pays the back benefits.

If a third of the claimants die or run out of legal muscle, the insurance company has reduced its claims by a third but they have still collected the premiums for those policies. If they win a third by default, and a third a trial…

Most big operations have small margins over time, a few % average over time. If you could cut your cost of goods sold by 2/3 by the simple expedient of not delivering the goods 2/3 of the time after being paid in advance, you’d have quite a nice racket going.

LTD insurance isn’t like most products, only a tiny fraction of the customers actually use the product, and you don’t want to make any repeat deliveries. So you could effectively ship a box full of air and dare the customer to pry the goods loose, if you could get away with that. Erisa lets them get away with it.
 
B_V said:
I'm fortunate that I found a good lawyer willing to take my case on contingency (meaning they don't get paid much unless we win the case) and that I could afford - both in $$$ and in energy - the testing required to prove my disability. The ERISA law is really messed up & tilted heavily in favor of the insurers. There are no jury trials and no punitive damages possible. So if an insurance company acts in bad faith and f*cks people over, the worst thing that can happen for them is having to pay the original benefit. In very rare cases the judge orders the insurance company to pay the plantiff's lawyer's fees, but my judge did not do that. So I'm a little bummed because her opinion is so strong and that is really the only punishment available under the law.
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Many congratulations, Brian, thrilled for you. Appalling you had to go through this in first place but I hope your winning your case gives hope to others.
 
Congratulations Brian @B_V this is fantastic news. I am so happy for you. This must have been so stressful and energy consuming, I hope now it's over you can get some rest and concentrate your limited energy on things you want to, not fighting a legal battle you should never of had to fight. Shame on these insurance companies, there needs to be some accountability for there actions and the harm they cause.

I really hope your case does set a precedent and changes thing for others in a similar situation.
 
Addendum: Upthread I said I was disappointed the judge did not award lawyer's fees (make Prudential pay my lawyers) but I misunderstood the process. We are asking the judge to award the lawyer's fees. Turns out it's a separate process. Federal lawsuits are long and complicated.
 
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