The Prudential Insurance Company terminated benefits under a group long term disability (“LTD”) policy that had been paid to a former Director of Field Operations employed by New York City. The claimant retained me to file a lawsuit against Prudential to recover her LTD benefits. Prudential agreed today to settle the litigation at an early stage.
A federal law called Employee Retirement Income Security Act of 1974
(“ERISA”) normally governs benefits provided by group insurance policies. There are several reasons why ERISA favors insurance companies when LTD claims need to be litigated. For example, ERISA precludes jury trials, limits discovery, and can adversely affect the standard of review.
A major reason why the litigation settled relatively quickly was that the case fell into an exception to ERISA. One exception to ERISA is when the group policy provides benefits for a governmental entity. Because the claimant worked for the City, a governmental entity, the case was exempt from ERISA. Free from the constraints of ERISA, the claimant asserted causes of action that would normally be pre-empted. It was those additional causes of action, and plenary discovery that prompted the settlement.