GINA PIKE v. HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY

Author Attorney Lloyd Bemis:

GINA PIKE

v.

HARTFORD LIFE AND ACCIDENT

INSURANCE COMPANY

Civil No. 4:17CV772

Gina Pike was receiving Long-term disability benefits payments from Hartford Life and Accident Insurance Company for a period of about 8 years when Hartford determined she was no longer disabled and discontinued her benefits.

She hired ERISA attorney Lonnie Roach of Bemis, Roach & Reed to help her reinstate her disability payments. Mr. Roach was successful in recovering her benefits.

The Defendant (HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY) paid Plaintiff’s claim (Gina Pike) for LTD benefits from April 24, 2008 through December 14, 2016, the period of time when Defendant determined Plaintiff met the definition of “disability” in the Policy.

However, after later determining Plaintiff was unable to prove she continued to be “disabled” under the Policy, Defendant discontinued LTD benefits effective December 15, 2016. The issue is whether Plaintiff is entitled to receive LTD benefits after December 14, 2016 under the Policy. Plaintiff seeks the benefits she has been denied plus pre-judgment and post-judgment interest, recovery of attorney’s fees and costs, clarification of her right to receive future benefits under the policy, and any other appropriate equitable relief.

The Magistrate Judge Caroline M. Craven determined that based on the Agreed Administrative Record, Plaintiff has demonstrated by a preponderance of the evidence that she cannot perform the essential duties, which includes the ability to work a full work week, of any occupation for which she qualifies.

Plaintiff has shown by a preponderance of the evidence that her disability persisted beyond December 14, 2016.

In her de novo review, the Magistrate Judge also considered the evidence relied upon by Defendant in justifying its termination of benefits and found no evidence of improvement in Plaintiff’s condition since Defendant previously found Plaintiff was unable to sustain full time work in any occupation.

The Magistrate Judge concluded it was improper for Defendant to cease Plaintiff’s LTD benefits, and Plaintiff, is entitled to the reinstatement of her LTD benefits beginning December 15, 2016. Thus, the Magistrate Judge recommended Plaintiff’s Motion for Judgment on the Record be granted and Defendant’s Cross-Motion for Judgment on the Record be denied. The Magistrate Judge also considered whether prejudgment interest, costs, and attorney’s fees should be awarded as requested by Plaintiff. The Magistrate Judge found Plaintiff is entitled to receive LTD benefits from December 15, 2016, and to recover pre-judgment interest on those unpaid benefits. She also found the circumstances support an award to Plaintiff for attorney’s fees and costs, in addition to the benefits amount owed to
her under the Policy.

• 33 – Report and Recommendation of Magistrate Judge
• 42 – Memorandum Adopting Report of Magistrate
• 2019-03-27-Pike-v-Hartford-Life

Author: Attorney Lloyd Bemis has been practicing law for over 35 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Bemis obtained dual board certifications from the Texas Board of Legal Specialization. Lloyd is admitted to practice in the United States District Court - all Texas Districts and has argued before the U.S. Court of Appeals, Fifth Circuit. Mr. Bemis is a member of the Travis County Bar Association. He has been active in the American Association for Justice and is a past Director of the Capital Area Trial Lawyers Association. Mr. Bemis and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.