The Case
Natasha LeJeune sought optional life insurance benefits from Prudential Insurance Company of America (“Prudential”), which were denied. Ms. LeJeune filed suit under ERISA. Prudential argued that Ms. LeJeune failed to exhaust her administrative remedies, a requirement under ERISA before being able to file a lawsuit.
According to Ms. LeJeune, Prudential denied her a “full and fair review” by failing to provide her with a copy of the claim file despite multiple written requests from her attorneys. Prudential did provide the claim file, but not until after Ms. LeJeune filed a lawsuit in federal court and until after the appeal deadline had passed. Ms. LeJeune also argued that, because she did not receive a “full and fair review”, her administrative remedies should be deemed exhausted because it was Prudential’s fault she was unable to timely appeal.
The court found that Prudential’s failure to provide Ms. LeJeune with the entire claim file prevented her from a reasonable opportunity for a “full and fair review” as required by ERISA. Accordingly, the court remanded the case back to Prudential for a decision.
Lawyers Specializing in Disability Insurance Claims
Because disability insurance law is complicated, it is important to get legal help from a lawyer who focuses on disability law.
As a law firm built to focus on disability insurance, our lawyers specialize in disability insurance. We spend every day working to get our clients long term disability benefits approved.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help.
If your claim for long term disability benefits was denied or being delayed by an insurance company, call us to speak with a disability insurance attorney.
We represent clients everywhere with:
- submitting a disability insurance claim;
- appealing a long-term disability denial;
- negotiating a lump-sum settlement; or
- filing a lawsuit against your disability insurance company.
