When a popular local lacrosse coach passed away after a heroic battle with leukemia, his widow and three teenage children believed that his death was covered by a life insurance policy issued by his employer. When they made the claim, Lincoln National Life Insurance company denied the claim, saying that even though the husband and father believe he was insured under his employers policy and even though his employer was paying premiums on the policy, he was not actually covered.
It took two trips to the Federal District court and one trip to the Fourth Circuit court of Appeals to prove Lincoln wrong. The decedent's family was recently awarded $500,000 in life insurance benefits and will now attempt to collect both interest and attorney fees for their five year effort.
The coach was diagnosed with leukemia in October 2014. After initially undergoing treatment he did well until a month before his death in September 2015. Because of his treatment, however, he was never able to return to work, which was in a secure facility in Northern Virginia. His employer, OGSystems, switched insurance companies in January 2015. Lincoln was the new insurance carrier for the company. The life insurance policy provided that those employees who are not currently at work were still covered under the policy under certain conditions.
Lincoln argued throughout the case that the husband was "totally disabled" as of the date the new policy took affect and thus was not covered. The Fourth Circuit Court of Appeals ruled that under the language of Lincoln's policy, the coach would've needed to have been disabled for at least 180 days prior to January 1, 2015. Since he had only been diagnosed in October 2014 to 180 days has not passed.
When the coach's widow came to our office she had only days remaining on her appeal to Lincoln for the benefits. We were able to get an extension of time and submit a full appeal. After Lincoln denied the appeal we sued in Federal District Court in Alexandria Virginia. About a year later that court ruled that Lincoln had abused it's discretion in not paying the benefits but that Lincoln had not fully considered the entire case. The District Court gave Lincoln another bite at the apple, remanding the case to Lincoln for reconsideration.
Lincoln reconsidered but did not change his position and we pursued the second half of the lawsuit in the district court. The district court ruled in favor of Lincoln and we appealed the case to the Court of Appeals. A full year after briefing was finished, we argued the case and about a month later the Court of Appeals ruled that Lincoln had again abused its discretion in denying benefits.
Because Lincoln has had full use of the money for five years we will ask the district court to force Lincoln to pay interest on the money it held while our client borrowed money to make ends meet. Because this is the case governed by ERISA we are also asking Lincoln to pay our attorney fees.
Update (4/27/21) Following the unamimous court ruling Lincoln filed a lengthy petition to rehear the case. On April 27, 2021 the Court, in a one sentence ruling, rejected Lincoln's petition. The case will now be returned to the District Court for a determination of interest and attorney fees.
The case is Stephanie Morris v. Lincoln National Life Insurance Company. You can listen to the oral arguments of Morris v Lincoln National Life Insurance Company here.