Case Studies

Disability Insurance Denial – Trial Avoided – Lump Sum Resolution Achieved

Darla Jones*, a divorced 48-year old with two adopted disabled children, worked as a paralegal for a major Seattle law firm until she became disabled from fibromyalgia, chronic fatigue syndrome (“CFS”) and diabetes. Fortunately, her employer provided her and her co-workers with a disability insurance policy. Ms. Jones filed her claim for disa…
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● Ettel v. Unum Life Insurance Company of America and Costco Wholesale Corporation
- Ms. Ettel became eligible to receive disability benefits, and Defendant Costco contracted with Defendant UNUM as to the determination, claim administration, and payment of these disability benefits. The Court ruled that UNUM wrongfully denied Ms. Ettel’s claim for benefits, and she received an award of benefits and attorney fees.
Resolution:

● Suzanne Tupper vs. APCO Worldwide Inc. and Unum Life Insurance Company of America
-Ms. Tupper’s claim for LTD benefits was wrongfully denied by UNUM. The Court determined that Unum conducted its claim review process in an arbitrary and capricious manner that resulted in the denial of valid claims despite Ms. Tupper’s presentation of objective medical proof of her disability, supported by her treating and examining physicians.
Resolution:

● Corsnitz v Aetna Life Insurance Company
-Ms. Corsnitz filed for long-term disability benefits with Aetna Insurance Company, pursuant to an ERISA disability insurance program provided by Boeing. All of claimant’s treating physicians opined that she was disabled due to chronic pain and fatigue caused by fibromyalgia, but Aetna refused to pay benefits. The Court determined that Aetna breached its fiduciary duties and Aetna paid all back benefits, costs of litigation, prejudgment interest, reasonable attorneys’ fees and Ms. Corsnitz was put back on claim.
Resolution:

● Lambert vs. Aetna Life Insurance Company
-Ms. Lambert’s disability benefits were wrongfully denied. The Court ruled that Aetna’s investigation and administration of claim was unreasonable and ordered a remand. Aetna then reinstated her benefits and paid attorney’s fees and costs.
Resolution: