After receiving benefits for 24 months, Sun Life Assurance Company of Canada decided to terminate the long term disability benefits being paid to a woman formerly employed by Westminister Services, Inc. With the help of her Florida disability attorney, the Plaintiff filed an ERISA lawsuit to recover these wrongfully denied benefits.
Facts of the Case Against Sun Life Assurance Company
Plaintiff’s onset of her disability occurred on or about December 28, 2003. It was eventually diagnosed as rheumatoid arthritis, which has become worse over time.
Under the terms of the Long-Term Disability Plan, Plaintiff was entitled to 60% of her earnings at the onset of disability. She would receive these benefits until the age of 65 so long as the disability continued.
Plaintiff received LTD benefits after the elimination period for a 24-month period under the “own occupation” provision of Sun Life’s Plan. Benefits would only continue after this period if the Participant was “totally disabled.”
Definition of “totally disabled” under the Plan: “Participant cannot perform any Gainful Occupation for which the Participant is reasonably qualified for by education, experience, or training.”
Sun Life found Plaintiff to be eligible for further benefits under the “any occupation” provision of the plan on July 21, 2006.
Plaintiff applied for and was approved for other sources of benefits, including Social Security disability benefits and a Workers’ Compensation settlement. Sun Life was made aware of this and adjusted the monthly payment accordingly.
Denial Of Sun Life Disability Benefits Claim
On June 5, 2009, Sun Life terminated the LTD benefits of the Plaintiff on the basis that there was a lack of proof of disability.
Florida Disability Lawyer Files Lawsuit Against Sun Life
According to the lawsuit, Plaintiff alleged that Sun Life is guilty of the following:
- Arbitrarily terminating the Plaintiff’s LTD benefits.
- Possible arbitrary discretion if Sun Life is guilty of not offsetting the amount of lump sum workers’ compensation when considering Plaintiff’s claim.
- Taking advantage of self-serving purposes of eliminating all of the Plaintiff’s benefits despite considerable proof that they should never have been eliminated in the first place.
Plaintiff has exhausted all administrative appeals, leading to the filing of this lawsuit.
Relief Sought By The Plaintiff In The Sun Life Lawsuit
Due to the actions of Sun Life, the plaintiff is seeking the following relief from the Court:
- A judgment where Sun Life pays all benefits owed, along with interest.
- Reasonable attorneys’ fees and costs.
- Other and further relief that the Court finds just and proper.