In 2012, William Gerard Hoh was employed by West Virginia as a full-time disability physician and was medical director of the West Virginia Public Employees’ Insurance Agency, where he performed administrative reviews and issued benefit decisions, according to a complaint filed Feb. 6 in Kanawha Circuit Court and removed to federal court March 2.
Hoh claims that year he began to experience painful symptoms in his arms and legs due to re-tethering of his spinal cord. On May 17, 2013, Hoh stopped working due to his back pain, neck pain, headaches and neuropathy in his upper and lower extremities and his physician determined he was unable to work, given his progression of symptoms.
Standard was the delegated authority to decide eligibility for benefits and pay claims for Hoh’s disability policy and Hoh’s physicians provided the insurance company with supporting medical records that confirmed that Hoh was unable to work full-time even at a sedentary occupation, according to the suit.
Hoh claims on May 1, 2014, Standard denied him both short-term and long-term disability and he timely filed an administrative appeal with the company.
On April 10, 2015, Standard upheld its earlier denial, according to the suit.
Hoh claims the denial was wrongful and it failed to consider the combined effects of all of Hoh’s illnesses and to provide a full and fair review of his disability claims.
Standard failed to conduct a reasonable investigation of Hoh’s entitlement to short-term and long-term disability benefits and failed, in good faith, to effectuate the prompt, fair and equitable payment of benefits, according to the suit.
Hoh is seeking compensatory and punitive damages. He is being represented by Ethan Vessels of Field Dehmlow & Vessels.
Standard is represented by Brian D. Morrison of Bailey & Wyant and Jacqueline J. Herring of Smith Von Schleicher & Associates.
U.S. District Court for the Southern District of West Virginia case number: 2:17-cv-01425