Ashley Milano  |  June 28, 2016

Category: Consumer News

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UnumLawsuitLogosPics_unum_iStock_disablity claim deniedA former pro football player’s disability insurance lawsuit has been trimmed down as a California federal judge dismissed claims, stating the ex-NFLer failed to show a plan-wide injury has occurred.

U.S. District Judge James Donato ordered the dismissal of certain claims plaintiff Charles D. brought in his disability insurance lawsuit.

Specifically, the judge tossed claims for equitable relief and breach of fiduciary duty alleged against the NFL Supplemental Disability Plan and the Bert Bell and Pete Rozelle NFL Player Retirement Plan (collectively, “the Plan”).

Judge Donato ruled that such breach of fiduciary duty claims under ERISA must be based on facts plausibly alleging that a claim beyond his own was mishandled or that a plan-wide injury has occurred.

“[Charles] brings the breach of fiduciary duty claim ‘both as an individual plan participant and on behalf of all other … participants and beneficiaries of the plan,’” the order stated. “But he fails to allege any facts showing that the plan follows a ‘uniform practice’ of misconduct for ‘all NFL disability claims.’”

The court heard oral arguments from both of the disability insurance lawsuit parties on June 8, and while Judge Donato sided with the Plan, he stated Charles could amend his complaint prior to July 6, 2016.

“The only examples of misconduct alleged in the complaint involve his own individual claim,” the order said. “That is not enough to sustain the fiduciary duty claim and it is dismissed with leave to amend.”

Disability Insurance Lawsuit Allegations

Charles, a former fifth-round pick by the Atlanta Falcons in 1988 out of UNLV and 12-year veteran of the NFL whose career involved playing for the Denver Broncos and the Tampa Bay Buccaneers, filed the disability insurance lawsuit against the NFL’s retirement plan in March for repeatedly denying him disability benefits he tried to claim.

Charles played 12 seasons in the league as a cornerback and says he suffered two major neck injuries while playing, according to a filing of his disability insurance lawsuit.

Charles says the neck injuries occurred when he was hit from the side while making a tackle in 1997, and again on a similar play two years later, his last in the league. He had a neck fusion surgery in 2000.

The former cornerback applied in 2008 for line-of-duty disabilities and was approved. However, he says his pain grew much worse, preventing him from working at San Diego sports performance training facility.

He then applied for Total and Permanent disability benefits in 2011. The T&P disability benefits are for former players “substantially prevented from or substantially unable to engage in any occupation or employment for remuneration or profit.”

His application and his appeal were denied.

In 2014, Charles tried to apply for the Total and Permanent benefits again. Despite reports from at least a half-dozen doctors supporting his case, he was again denied, as was his claim denial appeal.

One issue is that he was asked to see a retirement plan physician described for a “neutral physical medical examination.” This physician found that Charles was able to do desk or sedentary work.

Not only is Charles suing the Bert Bell and Pete Rozelle NFL Player Retirement Plan and the NFL Supplemental Disability Plan over his disability benefits claim denial, but also for failure to produce documents he requested.

The Disability Insurance Lawsuit is Case No. 3:16-cv-01413, in the U.S. District Court for the Northern District of California.

Do YOU have a legal claim? Fill out the form on this page now for a free, immediate, and confidential case evaluation. The bad faith insurance attorneys who work with Top Class Actions will contact you if you qualify to let you know if an individual lawsuit or Unum class action lawsuit is best for you. [In general, Unum bad faith lawsuits are filed individually by each plaintiff and are not class actions.] Hurry — statutes of limitations may apply.

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