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Mar 26, 2015 · pamela wallace, plaintiff, v. group long term disability plan for employees of tdameritrade holding corporation, et al., defendants.
Wallace v. Group Long Term Disability Plan for Employees of TDAmeritrade Holding Corporation et al (1:13-cv-06759), New York Southern District Court, Filed: 09/24/2013 - PacerMonitor Mobile Federal and Bankruptcy Court PACER Dockets
- Legal Issues Before The Pennsylvania District Court
- The Plan Administrator as The Proper Defendant
- Timeliness of The Plaintiff’S Claim
- Conduct of Sedgwick as Arbitrary and Capricious
- Determining The Appropriate Remedy
The District Court had to consider several issues before it in this case. First was the issue of who the plaintiff can sue as the both Sedgwick and the PNC Financial Services Group, Inc argued that the Plan should be the proper defendant. Second, the district court had to consider the argument of Sedgwick that the plaintiff’s claim was time-barred ...
The District Court ruled that the plaintiff was only seeking benefits from the assets of the Plan and the legal claim against Sedgwick was “essentially a claim that is only nominally asserted against the Plan Administrator and is, for all practical purpose s, a claim made against the relevant plan itself.” The Court ruled that the exercise of contr...
Sedgwick had argued that the plaintiff’s claim was time-barred as she did not apply for long term disability benefits within 90 days of when Total Disability began (June 5th 2007) as required by the terms of the Plan. The Court ruled that Sedgwick now could not rely on the 90 days limitation period as it HAD initially approved the plaintiff’s claim...
The court ruled that Sedgwick had acted arbitrarily and capriciously during its decision making process due to several factors: The reversal of Sedgwick’s initial approval for long term disability benefits claim without any additional medical evidence. The inconsistent treatment of the same medical information deemed sufficient for the initial appr...
Upon concluding that Sedgwick had acted arbitrarily and capriciously, the Court had to determine the appropriate remedy in this case. Here, the Court makes a distinction between the initial denial of benefits to a termination of benefits. To restore the status quo in this case, the Court ruled that the benefits should be reinstated as Sedgwick’s te...
Responsible for intake and processing of Medicare Enrollment applications, and works with the participant to accurately complete insurance applications while ensuring all government and...
- 169
- One Exchange-A WillisTowers Watson Division
- Richland College
- Dallas-Fort Worth Metroplex
Liked by Pamela Heisser. -- · I bring a wealth of knowledge to a Casualty Claims department based on my years of experience in both Technical and Managerial roles. · Experience: Sedgwick ...
- 40
- Sedgwick
- Southern Illinois University, Edwardsville
- Wilmington, Delaware, United States
We have extensive experience helping businesses manage short- and long-term disability claims, and all types of leave such as state, federal and municipal leave, military service, paid family and medical leave, and company-specific policies.
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