A disability lawsuit was recently filed by a California disability attorney in Federal Court against Prudential Insurance Inc. (Prudential) and Genetic Engineering Technology, Inc. The Plaintiff, William C., was employed as a microbiologist at Genentech. Due to his employment, Plaintiff was covered by Genentech’s long-term disability insurance plan, which was administered by Prudential.

In William C. v. Prudential Insurance Inc. and Genetic Engineering Technology, Inc., Plaintiff seeks the long-term disability benefits that should have been provided under the terms of the plan, but were wrongfully denied by Prudential.

The Facts Of The Case Against Prudential

Plaintiff was employed at Genentech for approximately thirteen years, first as a clerk, then as a facilities coordinator, and then as a microbiologist. He was a microbiologist from 2005 until 2011. In June 2009, Plaintiff was diagnosed with a metabolic syndrome that included symptoms of hypertension, hyperlipidemia, adult onset diabetes, and depression. This led to the Plaintiff being prescribed anti-depressant and anti-anxiety medications to treat or manage these symptoms.

In or about March 2010, Plaintiff could no longer work due to the increasing severity of these disabilities. In or about June 2010, Plaintiff was diagnosed with an acute stress disorder, along with resulting anxiety, depression, and somatization. This all prevented him from working as a microbiologist. Plaintiff’s doctors all agreed that he would clearly not be able to work due to his disabilities.

Plaintiff applied for short-term disability benefits due to his severe and debilitating acute stress disorder and depression. He has been unable to work since June 2010. Plaintiff supplied Genentech with his medical file. Plaintiff was informed by Genentech that the maximum period for short-term disability benefits was 180 days, which would be reached on December 26, 2010.

Plaintiff applied for long-term disability benefits. He was examined by Dr. Lawrence P. (Dr. P.) for a Workers’ Compensation, Agreed Medical Evaluator Psychiatric Evaluation on January 24, 2011. Dr. P. determined that Plaintiff was suffering from a total psychiatric disability that was caused by the issues and problems at Genentech.

Denial of Long-Term Disability Benefits By Prudential

Prudential denied Plaintiff’s claim for long-term disability benefits via letter dated January 19, 2011. Prudential explained that the reason for the denial was due to the lack of evidence showing that Plaintiff had impaired mental functioning due to stress and anxiety and that Plaintiff did not meet the definition of “disability” as defined under the terms of the plan.

Plaintiff filed an appeal of this denial, but Prudential again denied Plaintiff’s claim on June 8, 2011. Due to his exhausting all administrative remedies, Plaintiff has filed this lawsuit against Prudential.

Lawsuit Filed Against Prudential By California Disability Lawyer

According to the lawsuit, Prudential committed the following wrongful acts against the Plaintiff:

  • Failed to properly investigate and review both of the Plaintiff’s claims for long-term disability benefits
  • Failed to make a reasonable attempt to collect information to help assess Plaintiff’s claim
  • Failed to provide a detailed explanation as to why Plaintiff’s long-term disability benefits claim was denied despite the amount of evidence presented to them regarding Plaintiff’s condition
  • Failed to provide information on what else was needed for Plaintiff to prove his claim that he was disabled
  • Failed to identify the “normal unrestricted job duties” that Prudential claimed the Plaintiff could still perform despite his current condition
  • Failed to properly assess the medical evidence that the Plaintiff supplied Prudential with regarding his condition
  • Failed to give proper weight to Plaintiff’s treating doctors regarding Plaintiff’s medical condition
  • Failed to provide the long-term disability benefits that the Plaintiff should have been entitled under the terms of the plan

Plaintiff Seeks Following Relief From Prudential Via This Lawsuit

Due to the wrongful actions of Prudential, Plaintiff requests following relief from this Court:

  • A judgment that declares Prudential and/or other Defendants violated the terms of the plan, and thereby, Plaintiff’s rights under that plan
  • A judgment that Prudential and/or other Defendants pay all long-term disability benefits owed to the Plaintiff, along with all accrued interest
  • A judgment that Prudential and/or other Defendants stop withholding benefits and payments from the Plaintiff that should be paid to him according to the terms of the plan
  • A judgment that Prudential and/or other Defendants violated their fiduciary duty to the Plaintiff and to keep them from committing further violations in the future
  • A judgment that Prudential and/or other Defendants breached the long-term disability benefits contract and to keep them from committing further violations in the future
  • A judgment that removes Prudential as a fiduciary of the plan and replaces it with an independent fiduciary
  • A judgment that requires Prudential and/or other Defendants to pay all reasonable attorneys’ fees and associated court costs
  • A judgment that requires Prudential and/or other Defendants to pay all other relief that the Court declares to be just and proper