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WEST VIRGINIA RECORD

Friday, March 29, 2024

Man sues insurance company for wrongful denial of benefits

Insuranceclaim

CHARLESTON – A man is suing the Prudential Insurance Company of America for wrongfully denying him long-term disability benefits.


Mark E. Stewart was employed by NiSource Inc. and the company's long-term disability benefits was insured and administered by Prudential, according to a complaint initially filed March 27 in Kanawha Circuit Court and removed to federal court on April 24.


Stewart claims he applied for long-term disability benefits under the terms of the NiSource plan and submitted sufficient evidence in support of his disability in accordance with the terms of the plan.


However, Prudential arbitrarily and capriciously denied Stewart's entitlement to disability benefits, according to the suit.


Stewart claims he exercised his right to an administrative appeal of the defendant's decision to deny him benefits, and the appeal was denied on July 24.


The plaintiff also filed an application for Social Security disability benefits and his initial application was denied on Nov. 8, 2013, according to the suit. An appeal was filed on Nov. 18, 2013, and a hearing took place on Jan. 7.


Stewart claims a decision was rendered on Jan. 29 and in that decision, an administrative law judge determined that he was disabled under the Social Security Act and was entitled to Social Security disability benefits.


The plaintiff requested that Prudential consider the Jan. 29 decision of the administrative law judge, but the defendant failed and refused to do so, according to the suit.


Stewart is seeking recovery of all benefits due to him under the terms of the NiSource plan and pre-judgment interest. He is being represented by John J. Polak of Atkinson & Polak PPLC.


Prudential is represented by Jill E. Hall and Jessie F. Reckart of Bowles Rice LLP.


The case is assigned to District Judge Joseph R. Goodwin.


U.S. District Court for the Southern District of West Virginia case number: 2:15-cv-05182

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