In a lawsuit brought against ACE subsidiary Insurance Co. of North America by Pepsi-Cola Metropolitan Bottling Co. U.S. District Judge Stephen Wilson stated in 2011 that evidence against the insurer established a pattern of delaying payments on valid insurance claims.
ACE Unit Ends Payments, Forces Beneficiary to Sue
June 24th, 2013 - A Georgia woman has sued Insurance Co. of North America (INA), alleging that it terminated her disability benefits after she rejected its overture to buy out her long-standing claim.
Sharon Stephens was employed by Matsushita Communications Industrial Corp. of America until 1994 when she became disabled due to fibromyalgia and depression. According to her complaint, at the time, Matsushita offered employees long-term disability coverage issued by INA, an ACE Group unit. Stephens alleges that INA administered the policy, was a fiduciary and made all decisions as to which benefits were payable.
Stephens’ lawsuit claims that she was paid benefits by INA for a number of years but ultimately was offered a buy-out of her policy at what she called a reduced amount. According to her complaint, she rejected that offer and on April 18th, 2012, received a letter from the insurer that said her benefits were being terminated.
The complaint asserts that INA’s letter said that INA had not received updated medical information from the physician who was treating Stephens. Stephens claims she appealed this decision, saying that her medical condition made it difficult for her to focus for significant periods of time and that she has difficulty managing time.
According to her complaint, on June 29, 2012, INA upheld its denial and stated that its standards were different from those used by the Social Security Administration, which Stephens said had repeatedly found that she was disabled.
Stephens alleges that she appealed again, and that again INA denied her petition, exhausting her administrative remedies. Stephens’ suit against INA is filed in the U.S. District Court in Atlanta and charges that she is entitled to long term disability benefits that INA has refused to pay. The complaint alleges that INA ignored the opinions of her treating physician as well as those of a doctor who examined her on behalf of Social Security.
Stephens asked the court to restore her benefits retroactive to April 18, 2012.
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