Mr. Jacobs was injured at work. As a result of his injuries, he struggled to continue working and eventually had to cease work. He visited three (3) attorneys to assist him with various matters which were workers’ compensation and accident and sickness benefits. Unfortunately, counsel allegedly told him to focus on the workers’ compensation claim and worry about the accident and sickness claims later. Given the proof of loss limitations in the accident and sickness insurance policy, this would be precisely the wrong advice to give. Delaying past those time frames bars the claim. Apparently counsel never did assist with the accident and sickness insurance claims. Now there is a reported opinion in which this pro se plaintiff names the actual attorneys who assisted with the workers’ compensation case but allegedly dropped the ball on the accident and sickness case. The case is Jacobs v. Prudential Insurance Company of America, 2015 WL 4621743 (E.D. La. July 31, 2015).
Mr. Jacobs filed his case pro se, likely because any ERISA attorney reviewing the case knew he had made his claim too late and was bound to lose the case. Equitable tolling as to some of the limitation provisions was strenuously argued and, of course, Mr. Jacobs argued that he presented this matter to attorneys and they dropped the ball and so he ought to be able to equitably toll the claim. Of course, the court would not go along with that since, whether counsel put a case on the backburner or not, it is concern for counsel, not an insurance company. The court did attempt to provide some cover for these attorneys by noting that Mr. Jacobs would have lost his claim anyway because osteoarthritis contributed to his injuries. Perhaps that could have been overcome if the claim had been worked up very strongly during the claim process.
This case underscores the necessity of obtaining counsel with substantial ERISA experience. Do not put the matter on the backburner! Hire an ERISA lawyer at the first sign of a problem with your claim in Tuscaloosa and surrounding areas.