The O’Ryan Law Firm recently represented a former employee of Trinity Health, in South Bend, in a lawsuit against Hartford Insurance Company. Plaintiff worked for Trinity Health as a Food Service Manager for 24 years when she was forced to stop working for Trinity Health because she became disabled in July 2014 mainly due to chronic daily severe headaches. Hartford Insurance provided disability coverage to Trinity Health employees agreeing to pay income replacement benefits to any employee who became disabled due to injury or illness.
Plaintiff applied for her disability benefits offered through Trinity Health’s employee benefit plan, and insured by Hartford. Hartford approved Plaintiff’s claim beginning in December 2014. More than 12 months later, on January 12, 2016, a letter from Hartford informed Plaintiff that her benefits would cease on January 13, 2016. In the January 12, 2016 denial letter, Hartford stated, “We have determined that the weight of the medical evidence in your file does not substantiate functional impairment which continues to prevent you from performing Your Occupation on a full time basis. Therefore, benefits are not payable beyond January 12, 2016 and your claim has been closed effective January 13, 2016.” The Hartford policy has the following definition of “Disability”:
Disability or Disabled means you are prevented from performing one or more of the Essential Duties of: