Del Rio v. Toledo Edison Co.

This ERISA case, decided in 2005 , is a case dealing with the fiduciary duty that the employer owes the employee.

The Plaintiff/Insured was a former employee of the Defendant. She had worked for the Defendant for eight years before her employment was terminated in 1992. In 1994, she was awarded Social Security Disability benefits. She sued her former employer alleging that between 1994 and 2000 she periodically called the employer inquiring about her rights under the long term disability plan. Each time, the Defendant Employer informed her that she had not been an employee for ten full years, and so was not eligible for long term disability benefits under the employer’s plan. The court of appeals found that the employee failed to support her claim for breach of fiduciary duty because she presented nothing more than bare assertions and the employer made no material misrepresentations regarding the employee’s ineligibility for benefits. Nothing in ERISA’s civil enforcement provision suggested that a plan beneficiary should receive a benefit award based on a plan administrator’s failure to disclose required information. Furthermore, there was no evidence that the employer failed to honor a written request for information from the employee. The employee failed to show that her emotional problems, which were basis for her Social Security Disability claim, were the result of an on-the-job injury. The Court therefore affirmed the lower court.

Once again, we see that the importance of making the record in these cases is controlling. Here, the Plaintiff employee did not make the record to back up her claims and so she was unsuccessful. At the very least, and employee is going to have to demonstrate to the Court that the condition that is the basis for her claim was caused by an injury she suffered at work for the employer.

If you need assistance navigating your claim for short term or long term disability benefits under ERISA, or it is time to sue the insurance company, please do not hesitate to give Cody Allison & Associates, PLLC a call (844) LTD-CODY, (615) 234-6000. or send us an e-mail Cody@codyallison.com.  We provide representation nationwide and have successfully sued all the major insurance companies in many states. Our headquarters are located in Nashville, Tennessee.  We offer a free consultation and would love to speak with you.