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JUDGE OVERTURNS SUN LIFE INSURANCE DENIAL OF LONG-TERM DISABILITY AND LIFE INSURANCE CLAIMS

March 1, 2012

. . .
A client of ours will finally receive the long term disability and life insurance benefits she has been pursuing for four years! We recently received a favorable decision on her case from Judge Brooke Jackson, the newest member of the bench for the United States District Court for the District of Colorado. This claim was governed by the Employee Retirement Income Security Act (“ERISA”), and involved the denial of long term disability benefits and a life insurance benefit claim by Sun Life and Health Insurance Company. This case took more than four years to wind its way through the ERISA internal appeal and litigation process, but our client was ultimately successful. She has been awarded long term disability benefits, survivor benefits under the LTD policy and the full amount of the life insurance claim due to the death of her husband.

The court’s Order (and now Final Judgment) can be found at:

Bray v. Sun Life & Health Ins. Co., 2012 U.S. Dist. LEXIS 24131 (D. Colo. 2012)

Our client’s husband was a high-level travel executive. In 2005, his work performance began to suffer (as confirmed by numerous clients, co-workers, and others). He also started exhibiting odd behavior in his personal life. His physician incorrectly diagnosed these issues as depression. Shortly thereafter, he was terminated from his job, because his small (3 person) division was not as successful as it had been in the past and was no longer “a good fit” for the company. About six months later, he learned he had a massive brain tumor, which accounted for the pre-termination performance issues. Sun Life denied the disability claim, based solely on the fact that he continued to attempt work (albeit unsuccessfully) following his termination, and that his termination was not officially due to the disability. Sadly, this gentleman eventually died due to this brain tumor. A life insurance claim was then filed (under the “waiver of premium” provision found in his group life insurance claim), which Sun Life also denied.

It was quite apparent to us (and now the judge who has decided the case) that Sun Life made up its mind to deny the claim at the outset, and nothing was going to change its decision. The way Sun Life treated our client in the end of his life and his widow following his death was appalling. Sun Life’s decision has now been overturned by the court. All benefits are now payable, along with pre- and post-judgment interests and costs. We will also be seeking an award of attorney fees, as is permitted by ERISA statute.

Once in a while a wrong in the world can be righted . . . even in the world of ERISA.

Categories: Disability, ERISA Claims, Life Insurance

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