An employee of Nestle USA who was fully qualified to receive her disability benefits from Standard Insurance Company and her South Carolina disability attorney filed an ERISA lawsuit against the insurer in South Carolina Federal Court on July 1, 2011. As the sole entity responsible for determining the award of disability benefits to claimants, Standard Insurance Company was both the claim administrator and the fiduciary of the plan in the evaluation of Dawkins’ claim. Thus, Dawkins and her South Carolina disability attorney filed their claim under the Employee Retirement Insurance Security Act (ERISA).

Dawkins is Forced to Seek Legal Representation from a South Carolina Disability Attorney

Dawkins filed her Standard Insurance claim after being forced to cease work for a disability. Standard Insurance denied her claim for long term disability benefits, and Dawkins appealed, unsuccessfully. Once Dawkins exhausted all her administrative remedies for receiving her benefits, she had to hire a South Carolina disability attorney to fight the denial for her.

In her complaint, Dawkins and her South Carolina disability attorney claim that when Standard denied Dawkins’ disability benefits, the insurer was operating under a conflict of interest, that its decision was not based upon substantial evidence and that it was not the “result of a principled and reasoned decision-making process.” They accuse the insurer of “ignoring relevant evidence pertaining to [Dawkins’] claim and, instead, relying upon biased information and flawed expert opinions.”

Dawkins and Her South Carolina Disability Attorney Ask the Federal Court of South Carolina for Relief

Requesting that the District Court evaluate the administrative record of Dawkins, Dawkins and her South Carolina disability attorney offered case law and excerpts from 29 U.S.C.S. § 1132(a)(1)(B) to appeal to the Court for restitution. Should the Court determine in favor of Dawkins, Dawkins and her South Carolina attorney asked the Court to “exercise its inherent power to remand” Dawkins’ claim and force Standard to conduct a “full and fair” review of her claim. They also request that the Court award Dawkins attorney’s fees for the subject complaint as well. Dawkins and her South Carolina disability attorney ask the Court to award Dawkins her long-term disability benefits, attorney’s fees and costs in addition to any relief the Court deems appropriate including “pre-judgment interest on all benefits due from the point at which benefits were payable through the time of judgment.”