Huge Loss for Prudential Ins. Co In ERISA disability case
The case is Patricia Woods vs. Prudential Insurance Company of America.
The big issue in these cases is whether a federal judge and look at a claim denial "all over again" or whether he has to grant deference to the insurance company denying the claim.
In order to grant deference, the disability plan must have certain magic language in it "granting discretion."
The Court of Appeals ruled that standard language that Prudential uses in its plans does not grant discretion and that claims must be reviewed de novo.
This could effect thousands of Prudential group long term disability insurance policies and is a major victory for claimants.
Attorney Ben Glass is the author or Robbery Without a Gun, Why Your Employer's Long-Term Disability Policy May be a Sham.