My client suffered from degenerative disc disease requiring significant back surgery. He permanent limitations prevented him from returning to his work as a tugboat captain. He was successful in obtaining his long-term disability benefits from his company’s insurer, Prudential Insurance Company of North America.He received benefits for approximately 3 years at the maximum allowable rate under his long-term disability policy. However, at the 3-year mark, Prudential arbitrarily and capriciously changed its position on its policy terms and asserted the client was entitled to about $715 less per month in benefits. Prudential also claimed that based on its new calculations the client owed it an overpayment of over $25,000. In an effort to collect the overpayment, Prudential stopped paying my client.He sought my assistance to fight this change.After reviewing the file and case law as well as Prudential’s long-term disability insurance policy, we submitted a well-supported legal argument to Prudential arguing its change of position was arbitrary and capricious. Prudential overturned its prior decision. Prudential paid back the claimant for all amounts he was due and reinstated his benefits at the higher original amount. In total, the client received over $30,000 in benefits and had his right to an additional approximately $75,000 in lifetime benefits restored.
$75,000
