A proposed class of Boeing employees on Tuesday filed a lawsuit against Aetna Life Insurance Company and The Boeing Company, claiming that Aetna instituted claims-handling practices which improperly and systematically denied and terminated valid disability claims.
The suit, filed in United States District Court in Seattle, charges that Aetna mishandled countless short-term and long-term disability claims by failing to adequately review them, instead dismissing them, often arbitrarily. According to the complaint, Aetna also implemented a review process which placed an emphasis on certain evidence that supported a denial of disability, while dismissing evidence that strengthened the claim.
Fred Langer, attorney for the plaintiffs, said that Aetna’s handling of disability claims was an intentional, company-wide approach motivated by a desire to increase profits.
“We intend to show that in an effort to avoid paying disability claims and increase profits, Aetna implemented a sham claims-review procedure to justify numerous wrongful denials and terminations,” Langer said.
As stated in the complaint, Aetna breached numerous statutory duties in the administering of its short-term and long-term disability plans to Boeing employees, including failing to provide a full and fair review of disabled employees’ claims, and breaching fiduciary duties owed to members of the plan. According to the suit, breaches included heightening the requirements needed to prove disability; failing to collect all of the claimant’s medical records; disregarding the assessments of the claimant’s treating physicians in favor of those by Aetna’s paid claims reviewers; and ignoring prior social security disability awards.
According to Langer, Aetna’s alleged egregious mishandling of evidence is the crux of the proposed action against the company.
“One of the most disturbing aspects of this case is Aetna’s discriminatory treatment of evidence,” Langer said. “Aetna’s claims handlers would routinely cherry-pick pieces of subjective evidence in the claimant’s file to support a denial of benefits, while turning a blind eye to objective evidence and the testimony of numerous doctors which corroborated a legitimate disability,” said Langer.
Bonnie Biery, the suit’s named plaintiff, is reportedly a classic example of Aetna’s accused systematic claims-handling procedures and denial of benefits.
According to the complaint, Biery, whose disabling conditions include chronic fatigue syndrome and fibromyalgia, presented a myriad of evidence from treating and independent physicians which attested to her inability to work. However, despite the compelling evidence, Aetna reportedly used their own arbitrary review process to deny her long-term disability claim, the complaint states.
“Bonnie Biery is just one example of an innocent person who is at the mercy of an unlawful claims-handling process that is intended to disadvantage disabled persons,” Langer commented. “However, this suit is a wake-up call for Aetna demanding that it give an account for its predatory dealings with policyholders.”
The Boeing Company is the sponsor of short- and long-term disability benefits which are determined and administered by Aetna. As plan sponsor, Boeing is named as a defendant in the proposed class action, because of its willful or negligent participation in Aetna’s wrongful denials of disability benefits.
The proposed class includes Boeing employees who have been denied disability benefits by Aetna, since 1998. The suit seeks the reopening of administrative claims that were previously denied, the appropriate reinstatement of disability benefits owed to plaintiffs, change in of Aetna’s unlawful claims-handling practices, and additional damages owed to the class.
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