Jill Marcin suffers from kidney cancer, portal vein thrombosis, anemia and a variety of other serious medical conditions. In 2008, she filed a claim for long term disability insurance benefits under her policy with Reliance Standard. Reliance Standard denied her claim and her subsequent administrative appeal.
She filed one unsuccessful lawsuit in 2010 and a second one in 2013. She litigated her claim for seven years, nine years from the time she filed for LTD, before finally being awarded monthly benefits this past June. This speaks volumes about the challenges long term denied disability lawsuit plaintiffs face. But why does this happen so often?
This is not just about insurance companies’ persistence in bad faith claim denials or the hefty ligation budgets that make a strategy of delay possible. This is about a judicial rule that bars courts from reviewing even highly questionable decisions that deny employees plan benefits.
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In Marcin, the DC Circuit found a way to apply a different standard, a standard of de novo review that permits a court to review even the smallest errors of administrative judgment. That is how it found that Jill Marcin had, despite some ambiguous evidence, demonstrated that she was totally disabled.
This new rule could revolutionize ERISA litigation. The issue is also so important to the insurance industry that it is virtually certain to be the subject of a legal challenge. As of now, however, long term denied disability lawsuit plaintiffs may have a better chance for success in court than they have had in nearly 30 years.