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Ballwin resident claims Wellpoint denied disability without due cause

ST. LOUIS RECORD

Friday, November 22, 2024

Ballwin resident claims Wellpoint denied disability without due cause

Medical malpractice 02

ST. LOUIS — A Ballwin woman is suing Wellpoint Flexible Benefit Plan and Anthem Life Insurance Company, citing alleged breach of contract.

Rochelle Byrd filed a complaint on Jan. 5 in the U.S. District Court for the Eastern District of Missouri against Wellpoint, alleging that the company denied a valid disability claim without sufficient cause.

According to the complaint, Byrd said that on Sept. 19 she suffered damages from an improper health review conducted by a Wellpoint employee for her long-term disability (LTD) claim. The complaint states that the review was done over the telephone and consequently, the Wellpoint notified Byrd of her denial of LTD claim. This was despite findings from Anthem HRSolutions Center that declared Byrd to be disabled for the 180-day short-term disability (STD) period, the complaint states.

Byrd holds Wellpoint responsible because the company allegedly depended on an unreliable file review by an unqualified consultant who never observed or examined the plaintiff. The complaint said that Wellpoint also failed to explain how Byrd was found disabled for the entire 180-day STD period, but was denied for her LTD claim.

Byrd requests a trial by jury and seeks judgment against Wellpoint for benefits due, interest, reinstatement of other employee benefits, costs of action, attorneys' fees and further relief as deemed just. She is represented by Jonathan E. Shook of Shook & Johnson PLLC in St. Louis.

U.S. District Court for the Eastern District of Missouri Case number 17-cv-00008

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