Court: United States District Court, Northern District of Indiana, Fort Wayne Division
Insurance Carrier: Reliance Standard Life Insurance Company
Employer: Medtronic
Claimant’s Occupation: Senior Case Specialist
Background: A Long-Term Disability Claim Interrupted
Megan King, a Senior Case Specialist for Medtronic, suffered significant physical and mental impairments as a result of a neurocognitive disorder related to her pituitary gland. As a result, she was approved for long-term disability benefits under Medtronic’s plan, which was administered by Reliance Standard Life Insurance Company. After four years, Reliance Standard terminated her physical disability benefits, claiming that she was only eligible for mental disability benefits, which the plan limited to 12 months.
In July 2023, King appealed this decision, submitting evidence of her continuing physical disability. Under the Department of Labor’s (DOL) claims procedure regulations, Reliance Standard had 45 days to issue a decision or properly request an extension. When it failed to do so by the September 2023 deadline, King filed a lawsuit to protect her claim. Reliance Standard ultimately denied her appeal nearly four months after the lawsuit was filed.
Dispute Over Post-Exhaustion Evidence
The dispute centered on whether Reliance Standard could introduce evidence gathered after the claim was deemed “exhausted” due to its missed deadlines. King argued that allowing such evidence would unfairly give Reliance Standard additional time to build its case, undermining DOL deadlines designed to protect claimants. Reliance Standard conceded that its response was late, but still sought to include new evidence, citing the court’s discretion in ERISA cases.
The Court’s Decision: Upholding Claimant Protections
The court ruled in favor of King, excluding all evidence gathered after the administrative exhaustion deadline. The judge emphasized that allowing post-exhaustion evidence would undermine the purpose of ERISA deadlines, which balance the interests of plan administrators and claimants. As a result, the court limited its review to the evidence gathered prior to September 14, 2023, the exhaustion date.
Need Help Fighting for Your Benefits?
If your long-term disability benefits have been unfairly denied or terminated, and your insurance carrier has failed to meet its obligations, you don’t have to face the fight alone. Contact the Ortiz Law Firm today for experienced and compassionate legal representation tailored to your case. Whether you’re facing similar ERISA disputes or other issues with your insurance provider, we’re here to help. Call (888) 321-8131 to schedule a free case evaluation today.
Disclaimer: This case was not handled by disability attorney Nick A. Ortiz. The court case is summarized here to give readers a better understanding of how Federal Courts decide long-term disability ERISA claims.
Here is a PDF copy of the decision: King v. Reliance Standard
