The Supreme Court has just agreed to take a new LTD case involving an employee who filed suit against long-term disability benefits insurer under Employee Retirement Income Security Act (ERISA), arising out of denial of her request for disability benefits.
Julie Heimeshoff worked at Wal-Mart from 4/29/1986 until 6/8/2005. During that time, she became eligible for her company’s long term disability plan. In 2005, she began suffering from chronic pain, including lupus. In May 2005 her “pain, fatigue, and other disabling symptoms increased.” Ms. Heimeshoff “tried to continue working despite her medical conditions,” but “due to her significant pain, extreme fatigue, and cognitive impairment, she had to stop working on or about June 8, 2005,” and has since been unable to sustain full-time employment due to her conditions.
Under her LTD plan with The Hartford, there was a three year limitation period in which she had to file her claim in federal court. This limitation period began running when her proof of loss was due under benefit plan, not upon final denial of request for benefits.
She filed her LTD claim with The Hartford and it took them over three years to deny her claim. Since it took more than three years for her denial, her claim for relief was barred in federal court. If she filed her claim in federal court before her remedies with The Hartford LTD plan were exhausted, the federal court would have dismissed the claim, because she had not completely gone through The Hartford’s claims process.
Seems like an insurance company can just delay a claim until it is barred from review by the federal court.