Lelu v. Hartford Live & Accident Ins. Co.

In this 2009 case, the employer was the plan sponsor and plan administrator of an ERISA long-term disability benefits plan. The insurance company was the claims administrator of the plan. The insured sought to depose a nurse who worked for the employer. The nurse was responsible for processing doctors’ notes for the employer’s employees who received sick pay and short-term illness benefits. The employer’s short-term illness program was not administered by the insurance company. The insurance company opposed the discovery because the nurse would not provide information regarding or participate in its decision to deny the insured long-term disability benefits. The court found that the insured had not shown that there was something in the administrative record or other evidence that established that the insurance company was aware of information in the possession of the employer that it should have considered in making its decision on the claim for long-term disability benefits. Absent such a showing, discovery from the nurse or others regarding the employer’s short-term illness and/or salary continuation program decisions was not appropriate.

Outcome: The motion for a protective order was granted.

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.