Louisiana Record

Tuesday, July 23, 2019

Employee faults Aetna for failing to provide ERISA benefits

By Carol Ostrow | Jun 1, 2015

| Shutterstock

A woman brought suit against her employer’s insurance carrier in a workplace benefits matter originating in 2012.

Monica Bourque of Milton filed a lawsuit against Aetna Life Insurance Co. in the U.S. District Court of the Eastern District of Louisiana on May 20, citing employment law violation regarding a workplace matter beginning in September 2012.

Bourque was a plan participant and beneficiary of an Employee Retirement Income Security Act plan created by her employer, the suit states, including a group disability policy. The defendant is a foreign corporation doing business in Louisiana.

The complaint indicates that Bourque filed a claim for disability benefits when her medical condition allegedly prevented her from working full time. The plaintiff avers that Aetna unlawfully denied her benefits despite having awarded her partial benefits between Sept. 22, 2012, and Aug. 21, 2013, claiming lack of medical evidence.

Bourque’s lawsuit contends that Aetna’s denials are based on insubstantial evidence and constitute an abuse of discretion; that the defendant habitually uses the appeals process to support denials rather than to review evidence impartially; and handled her claim in an unlawful manner.

Requesting actual damages in the amount of unpaid past and future benefits; plus pre- and post-judgment interest, attorney’s fees, expenses, and court costs, she is represented by Reagan Toledano, James F. Willeford, and Shane Pendley of Willeford & Toledano in New Orleans.

U.S. District Court of the Eastern District of Louisiana Case 2:15-cv-01709-JCZ-MBN.

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