The plaintiff was a 49-year-old Northern Virginia businessman who had a private (non-ERISA) long-term disability insurance policy with Penn Mutual for many years. In 1980 he began to complain of chronic m U.S.C. le stiffness and pain. In 1995 he had an automobile accident and was later diagnosed with fibromyalgia. This was confirmed by his primary care physician and a rheumatologist.
He submitted a claim for “partial disability” with Penn Mutual, who began paying partial monthly benefits. In 2002 the company had an independent medical examination done by Dr. Ross Myerson, of Maryland, who opined that plaintiff had no trigger points diagnostic of fibromyalgia and that he had simply made a “lifestyle choice” to cut back on the hours that he worked.
In 2003 the insurance company sent the plaintiff an “activities log” in which the insured was told to track his activities for the week. At the same time video surveillance was ordered by the insurance company. The insurance company then claimed that the video was not consistent with the self report of activities. Penn Mutual refused to produce the video or any claim file and threatened to close the claim and terminate the disability payments. After an initial offer of $166,000, the parties agreed to a lump sum buyout of the policy for $300,000, and the case was settled before litigation began.
Type of Action — Insurance
Type of Injuries — Fibromyalgia leading to partial disability
Name of Case — Steiner v Penn Mutual Life Insurance Company
Court / Case No. — Settled before litigation
Special Damages — Benefits of $5,790 per month
Awarded / Settled — Settled
Amount — $300,000
Insurance Carrier — Penn Mutual Life Insurance Company