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Ben Glass
Ben Glass
Attorney • (703) 584-7277

Huge Victory in Virginia for Long-Term Disability Claimants

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Yesterday, the Fourth Circuit Court of Appeals dealt a major blow to Prudential
Insurance Company of America in an ERISA group long-term disability
case involving a claim for benefits.

The case is Patricia Woods v. Prudential Insurance Company of America.

The
big issue in these all of these ERISA disability cases is whether a federal judge can look at a claim
denial “all over again” or whether he has to grant deference to the
insurance company administrator denying the claim.

In order to grant deference, the disability plan must have certain magic language in it “granting discretion” and the language must be stated in a very specif way.

The
Court of Appeals ruled that standard language that Prudential uses in
its plans does not grant discretion and that claims must be reviewed de
novo.

This could effect thousands of Prudential group long term disability insurance policies and is a major victory for claimants.