FORT LAUDERDALE — A case involving a former TIN Inc. employee seeking reinstatement of his long-term disability benefits under the Employee Retirement Income Security Act (ERISA) is not Standard Insurance Co.’s first experience with this type of lawsuit, according to one Florida attorney.
The lawsuit in the case, Timothy Lang v. Standard Insurance Co., was filed on Feb. 3 in the U.S. District Court for the Southern District of Florida. According to the complaint, Lang was allegedly hurt in 2012. He received disability insurance benefits until June 2016 as a participant under the Temple-Inland Group Long Term Disability Insurance Policy, which was issued by Standard Insurance.
“Lang brings this action to recover long-term disability benefits due to him under the terms of an employee welfare benefit plan, to enforce his rights under the plan and to clarify his rights to benefits under the terms of the plan,” the complaint said.
According to the complaint, Lang alleges that Standard Insurance ended his benefits even though he still met the disability plan’s definition of disabled. When Standard Insurance initially denied Lang’s request for continuation of benefits, Lang appealed. The insurer upheld its previous decision on Oct. 7 and told Lang his administrative remedies had been exhausted.
Florida attorney Paul M. Sullivan Jr. said “reimbursement” cases like Lang’s are one form of litigation that fall under decades-old preemption provisions.
“ERISA preemption in April will be some 30 years old,” Sullivan told the Florida Record. “ERISA preemption is a murky bog that surprises most people when it pops up.”
Sullivan said preemption has even posed problems for the country’s highest court.
“The U.S. Supreme Court itself has had a long and difficult road to tread in trying to disentangle the Gordian knot,” he said.
According to Sullivan, along with larger preemption issues such as whether state court cases under state law can go forward, there are a lot of smaller preemption problems, including the question of whether a special needs trust for a severely injured accident victim could be invaded to pay back a self-insured health plan, whether any of the states could demand reporting of health outcome statistics for those insured under ERISA health plans and more.
“How about a letter from an insurance company saying it made a mistake over a decade ago and asking for hundreds of thousands of dollars back?” Sullivan said. “These ‘reimbursement’ cases are really something. In a sense they too are little-preemption cases, in that they deal with remedies available under ERISA.”
Sullivan said the general approach in ERISA cases regarding cut-off benefits is to reinstate the plaintiff to his or her prior situation, and Standard Insurance is not new to this type of litigation.
“Of course, Standard has been the subject of other lawsuits of this nature,” he said.
In response to the lawsuit, Bob Speltz, senior director of public affairs for Standard Insurance, told the Florida Record the company has no comment.
“We’re aware of the allegations as stated in the complaint and have no additional comment at this time," he said.
Lang’s attorneys, Alexander A. Palamara and Gregory Michael Dell of Dell and Schaefer, did not respond to requests for comment on the lawsuit.