The Plaintiff, Barbara M., with the help of her Florida Disability Lawyer, filed this lawsuit against Reliance Standard Life Insurance Company and Hope Hospice & Community Services, Inc. for the wrongful denial of short term and long term disability benefits.

In Barbara M. Vs Reliance Standard and Hope, Plaintiff seeks rightful reinstatement of Short Term and Long Term Disability Benefits as defined by the Plan.

Plaintiff’s Eligibility of Benefits Under The Plan

Plaintiff worked for Hope, which enabled to be eligible for both its STD and LTD Plans as defined by ERISA regulations. Reliance and Hope were supposed to supply benefits in accordance with stringent trust principles and “solely in the interest of plan participants and beneficiaries” with the “care, skill, prudence, and diligence under the circumstances then prevailing,” as well as in accordance with the plan instruments. Plaintiff applied for the Plan and was accepted for coverage.

Plaintiff became disabled due to a work-related injury according to the terms of the Plan and filed for STD benefits and non-plan Workers Compensation benefits as defendant Hope instructed.

Reliance Standard Denies STD benefits, Hope Approves Workers Compensation benefits

Plaintiff was denied STD benefits by Reliance Standard, but did receive Workers Compensation benefits from Hope for all of the 24 months she was eligible for them. Plaintiff filed a LTD claim with Hope, but was denied and told that she could not receive LTD benefits while Workers Compensation benefits were in effect. These benefits ran out on October 1, 2010.

Plaintiff filed for LTD benefits after Workers Compensation benefits ran out as per Hope’s instructions. Plaintiff’s husband died on Thanksgiving Day, November 25, 2010. Hope terminated Plaintiff’s employment on December 10, 2010.

Hope instructed Plaintiff to timely file plan applications and Proof of Loss Statements within 31 days to Reliance Standard to continue receiving plan benefits. Reliance Standard rejected all plan applications. Plaintiff filed administrative appeals of these denials on August 15, 2011, challenging Reliance Standard’s initial determinations.

Reliance Standard never addressed the appeals, and as a result, Plaintiff has administratively exhausted her appeals, leading to the filing of this lawsuit against Reliance Standard and Hope.

Lawsuit Against Reliance Standard and Hope Filed

Plaintiff claims in lawsuit that Plaintiff is entitled to Waiver of Premium, Conversion, spousal VTL, and LTD benefits. Plaintiff requests “de novo review” as the appropriate standard, since the plan does not specify a procedure for written appeals. Additionally, the Court does not have a standard determined by the Plan in which to defer to.

Plaintiff claims for the wrongful denial of ERISA benefits that were outlined in the Plan. Plaintiff has and continues to incur losses as a result of the plan’s wrongful denial of benefits.

Plaintiff Wants the Following Judgment

Plaintiff wishes to receive a judgment against Defendants Reliance Standard and Hope that includes the following provisions:

  • Reinstatement of benefits as defined in the Plan
  • Monetary award
  • Pre-judgment interest
  • Attorney’s fees
  • Associated court costs
  • All other relief decided by the Court as being fair and proper