Bollwerk & Tatlow, LLC recently obtained a favorable ruling in federal court on behalf of Raymond Martin. Mr. Martin was an employee at Anheuser-Busch who stopped working in 2003. While he was an employee, Mr. Martin was enrolled in a group life insurance plan through AB that provided benefits due to total and permanent disability.
However, Mr. Martin had no idea he was enrolled in the life insurance plan, since he never received any Summary Plan Description or other documents from AB about the plan. This was a direct violation of the Employee Retirement and Income Security Act (“ERISA”), a federal law that requires plan administrators—like AB—to furnish Summary Plan Descriptions to all participants in benefit plans.
Mr. Martin did not find out about the plan until years after he stopped working. When he finally made a claim for disability benefits in 2010, it was denied by Aetna Life Insurance Company for being several years late, as the plan required all claims to be made within 36 months after an employee stopped working due to disability. Of course, Mr. Martin did not know this and was not able to make a timely claim.
That did not stop AB and Aetna from denying his claim and attempting to benefit from their misconduct. All Mr. Martin has ever wanted is the right to make a claim for benefits, just like he should have had in the first place.
Mr. Martin came to Bollwerk & Tatlow, LLC and attorney Phillip A. Tatlow after he was denied total and permanent disability benefits. A lawsuit was filed on his behalf against AB and Aetna. The Defendants then tried two times to have Mr. Martin’s claims for equitable relief thrown out of court.
Bollwerk & Tatlow, LLC argued that Mr. Martin had every right to sue the Defendants, and that he should have his day in court. Attorney Jeffrey A. Herman wrote the briefs on behalf of Mr. Martin. After eight total briefs on both sides, and more than 120 pages of arguments, the U.S. District Court ultimately sided with Mr. Martin on every single issue raised.
The Court's ruling is a victory for all employees, like Mr. Martin, who are enrolled in employee benefit plans governed by ERISA. It reaffirms that employees are entitled to their day in court when crucial plan information is withheld from them and they suffer harm as a result.
The full opinion by U.S. District Court Judge Jean Hamilton can be read here.