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Aetna denied claim without reviewing records from treating physician, woman alleges

ST. LOUIS RECORD

Sunday, November 24, 2024

Aetna denied claim without reviewing records from treating physician, woman alleges

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ST. LOUIS — A woman is suing an insurance company and a plan administrator, citing alleged violation of the Employment and Retirement Income Security Act (ERISA).

Kelly Porter filed a complaint on March 8 in the U.S. District Court for the Eastern District of Missouri against Aetna Life Insurance Co., Ricoh USA Inc., Leigh Gordon and Ricoh USA Inc. Short Term Disability Plan, alleging that they violated ERISA through non-payment of plan benefits.

According to the complaint, the plaintiff was an employee of Ricoh in Fenton, and on April 15, 2016, she was unable to continue working due to asthma with acute exacerbation, cough and acute bronchitis. She alleges that she has suffered loss of short-term disability benefits from the defendants' denial of the plaintiff's disability claim. The plaintiff holds the defendants responsible because they allegedly failed to acknowledge the findings of the plaintiff's treating physician, failed to take into consideration the medical records of the treating physician and evaluated the medical and vocational evidence in a biased manner.

The plaintiff seeks declaratory relief, interest, attorney's fees, costs and other relief that the court deems necessary. She is represented by Evan M. Bettag and Andrew H. Marty of Chassaniol & Marty LLC in St. Peters.

U.S. District Court for the Eastern District of Missouri Case number 17-cv-00857

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