Personal Injury Law

Huge Victory in Virginia for Long-Term Disability Claimants

By Ben Glass

Yesterday, the Fourth Circuit Court of Appeals dealt a major blow to Prudential Insurance Company of America in an ERISA group long-term disability case involving a claim for benefits.

The big issue in these all of these ERISA disability cases is whether a federal judge can look at a claim denial "all over again" or whether he has to grant deference to the insurance company administrator denying the claim.

In order to grant deference, the disability plan must have certain magic language in it "granting discretion" and the language must be stated in a very specif way.

The Court of Appeals ruled that standard language that Prudential uses in its plans does not grant discretion and that claims must be reviewed de novo.

This could effect thousands of Prudential group long term disability insurance policies and is a major victory for claimants.

Full post as published by Northern Virginia Personal Injury Lawyer on June 12, 2008 (boomark / email).