A Houston resident has sued a major insurance carrier for disability benefits.
Albert Chavarria filed a lawsuit March 31 in U.S. District Court Eastern District of Louisiana against Metropolitan Life Insurance Co. seeking disability benefits.
According to the complaint, Chavarria filed for disability benefits under an ERISA plan created by his employer, DDH Investments, "because his medical condition precluded him from continuing to perform his duties of his job on a full-time basis."
The suit says MetLife denied his initial claim and his appeal but on Dec. 5, 2014, the court judged in Chavarria's favor by ordering MetLife to pay him $1,035.13, plus interest. The complaint states the court has expressed "no opinion on [Chavarria's] entitlement to long-term disability benefits during the 'any occupation' period" under the policy.
The suit says Chavarria's attorney contacted a MetLife claims specialist, who told her the company would make a decision on long-term benefits "as soon as possible" but a month has passed since being told that.
According to the lawsuit, MetLife has "abused its discretion" as plan administrator: by denying Chavarria's claim in bad faith; by failing to consider "the disabling, synergistic effect" of Chavarria's medical problems; and by failing to consider his "medical condition in relation to the actual duties of his occupation or of a suitable alternative that would provide substantial earnings."
Finally, the complaint alleges, "MetLife's administration of this claim corrupts any reasonable meaning of 'full and fair review' that ERISA requires."
Chavarria seeks all past and future benefits due to him under his plan, plus pre- and post-judgment interest, court costs and attorney fees. He is represented by attorney Reagan L. Toledano of Willeford and Toledano in New Orleans.
U.S. District Court Eastern District of Louisiana, case number: 2:15-CV-993.