On August 8, 2011 a FedEx employee and his Tennessee disability attorney filed a lawsuit against FedEx and Aetna, Inc. in the United States Federal Court for the insurer’s “wrongful refusal to pay Long-Term Disability benefits due.” As an employee benefits insurance plan, the Aetna plan is considered a welfare benefit plan, meaning that the plan’s administration must comply with the Employee Retirement Insurance Security Act of 1974 (ERISA). And, according to the employee and his Tennessee disability attorney, Aetna violated ERISA when the insurer did not fully and fairly review Smith’s disability claim and breached its fiduciary duty to Smith.
History of Claimant’s Disabling Condition
Employed from 1985 until 2007 as a Senior Aviation Mx Tech for FedEx, “Smith has been diagnosed with ischemic heart disease with history of myocardial infarction, ischemic cardiomyopathy with multiple stent placement, abdominal aortic aneurysm, peripheral vascular disease, hypertension, hyperlipidemia, decreased renal function, asplenia, diabetes mellitus and chronic pancreatitis.” Unable to work the requisite twenty-five hours under Fed Ex’s Aetna plan, Smith fully qualifies as a recipient of his long-term disability benefits.
Initially, Smith was approved for his disability benefits and received disability benefits from November 26, 2007 until November 26, 2009. In October of 2008, Smith applied to and was approved for Social Security Disability benefits as well. Then, in November of 2009, Aetna, after reviewing Smith’s claim, denied further payment on his disability claim. And, as all his appeals have been exhausted, Smith and his Tennessee disability attorney filed this lawsuit against Aetna.
Aetna Claimant and His Tennessee Disability Attorney Ask for Relief
Having been denied his rightful disability benefits and loss of insurance coverage, Smith and his Tennessee disability attorney have appealed to the District Court to:
- Issue a declaratory judgment declaring that Smith is “entitled to continuation of the group long term disability benefits in the proper amounts as set forth in the Plan;
- Require FedEx and Aetna to provide Smith details of his entitled benefits so he and his Tennessee disability attorney can correctly calculate Smith’s entitled benefit payments;
- Issue an order stating that FedEx and Aetna must “forthwith” pay the full amount of Smith’s disability benefits owed him, including interest on all unpaid benefits;
- Disgorge FedEx and Aetna of any profits or gains they have benefited from by withholding Smith’s disability benefits payments;
- Award Smith reasonable attorney’s fees reimbursement; and
- Provide Smith with any other relief the Court thinks is “just and appropriate.”