West Virginia Record

Monday, February 24, 2020

Huntington woman sues Northwestern Mutual, company says she doesn’t qualify for benefits

By Kyla Asbury | Nov 23, 2016

Insurance 05

HUNTINGTON – A Huntington woman is suing Northwestern Mutual Life Insurance Company, claiming she is entitled to disability benefits. The insurance company says her inability to work are reasons that are not covered under its policy.

Lindsey T. Watson-Earl filed the lawsuit against Northwestern in the U.S. District Court for the Southern District of West Virginia, alleging that she had purchased three policies from the insurance company in 2008, 2009 and 2012.

Watson-Earl is the wife of Daniel Earl, a managing partner at Dinsmore Shohl in Huntington.

Watson-Earl claims she became disabled. And in 2015, she says she submitted a claim to Northwestern for disability benefits under the policies.

On Jan. 7, Northwestern informed Watson-Earl her claim had been approved for total disability benefits under two of the policies, but that it was engaged in an ongoing review of the third policy, according to the suit.

Watson-Earl claims on Jan. 26, Northwestern informed her that she was under a legal disability, as opposed to a factual disability and that her claims under all of her policies would be subject to identical exclusionary language under Section 3.2 of each policy.

The correspondence noted that several life insurance policies also issued by Northwestern to Watson-Earl did not contain the exclusionary language cited in Section 3.2 of the disability policies and, as a result, she would remain eligible for the Wavier Benefits on those life insurance policies as long as she remained disabled, according to the suit.

Watson-Earl claims Northwestern also informed her that it would continue its review of whether the third policy was properly issued, but that regardless, the third policy also contained the exclusionary language and would provide no coverage for her claim.

On Feb. 9, Northwestern informed Watson-Earl that its review of the third policy had concluded with a determination that the issuance of the policy was appropriate, according to the suit.

Watson-Earl made repeated demands to Northwestern for payment of benefits on her claim and forwarded evidence in support, including an affidavit from her treating healthcare provider.

Nonetheless, the defendant denied that the disability benefits are properly payable under the policies because of the improper application of exclusionary language, according to the suit.

Watson-Earl claims the defendant has breached its contract with her and has acted in bad faith.

Watson-Earl is seeking declaratory judgment by the court that coverage exists under the policies and compensatory and punitive damages. She is being represented by L. David Duffield and Chad S. Lovejoy of Duffield, Lovejoy, Stemple & Boggs.

In its Nov. 8 answer to Watson-Earl’s complaint, Northwestern denies Watson-Earl’s allegations that she is due disability benefits.

Northwestern argues that Watson-Earl failed to mitigate her damages if any exist; denies that it acted in bad faith toward Watson-Earl or that it violated any applicable law, statute or regulation or breached any duty owed to Watson-Earl; and denied that it is liable for any sum or money damages in any amount.

“Defendant’s actions herein met the test of reasonableness in all fashions and, as a result thereof, no actions for violation of the West Virginia Insurance Unfair Trade Practices Act … West Virginia Unfair Claim Settlement Practices Act … or West Virginia Unfair trade Practices is maintainable,” the court document states.

Northwestern “respectfully demands” that the plaintiff’s complaint be dismissed with prejudice and judgment be entered on behalf of the defendant. Northwestern is represented by Robert L. Massie, Marc E. Williams and Megan B. Davis of Nelson Mullins Riley & Scarborough.

Watson-Earl also filed for a protective order on Oct. 10, stating that her claims require discussion of her private personal health information, which includes information that would otherwise be deemed to be protected under the Health Insurance Portability and Accountability Act.

“Specifically, plaintiff’s claim involves discussion of sensitive medical information regarding plaintiffs’ health, including mental health records, which are generally subject to privacy protections under State and Federal Law,” the filing states.

In its response to her protective order, Northwestern opposed it, arguing that her motion asks the court to limit or prohibit any non-parties’ remote access to the pleadings in the case beyond the original complaint.

“In sum, the plaintiff seeks to have the courts of the United States decide a dispute between litigants without allowing the public access to any of the proceeding whatsoever,” Northwestern wrote. “This is contrary to applicable law.”

Northwestern argued that under clear precedent, the public has a right to access documents that play a relevant and useful role in the adjudicative process.

“This, by its very nature, would necessarily suggest that a blanket protection of the entire court file and docket in this matter is not appropriate,” Northwestern wrote.

In 2014, Watson-Earl pleaded guilty to attempting to acquire and obtain the amphetamine Adderall XL by misrepresentation, fraud, forgery, deception and subterfuge.

She signed an agreement with prosecutors, stating that she submitted a forged prescription slip to a pharmacist at a Rite-Aid Pharmacy in Huntington in hopes of obtaining the amphetamine.

The case is assigned to Circuit Judge Robert C. Chambers.

U.S. District Court for the Southern District of West Virginia case number: 3:16-cv-09267

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Organizations in this Story

Duffield, Lovejoy, Stemple & Boggs PLLCNelson Mullins Riley & Scarborough