PHILADELPHIA — A patient is suing her health insurance providers, alleging she was wrongfully denied long-term medical benefits for her paraplegia.
Kimberly Lashi filed a lawsuit Jan. 19 in the U.S. District Court for the Eastern District of Pennsylvania against Reliance Standard Life Insurance Company of Philadelphia, Matrix Absence Management Inc. of Harrisburg, and Temple University Health System Inc. of Philadelphia, alleging violation of the Employee Retirement Income Security Act (ERISA).
According to the complaint, Lashi was insured for long-term disability benefits as issued by the defendants at all times relevant to the case. Under the terms of the plan, Reliance Standard Insurance Company was appointed as the claims review fiduciary with the discretionary authority to interpret the policy and determine eligibility for benefits, the suit says.
Lashi alleges Reliance did not exercise this authority and instead retained Matrix as a third-party administrator. The plaintiff reports a history of medical problems including paraplegia, for which she was granted long-term disability Dec. 11, 2012, by Matrix.
At the end of 24 months, Lashi says she was required to provide evidence of her disability. After a series of tests and letters sent between the plaintiff and the defendants, the defendants refused to provide Lashi with medical benefits, to which she says she is entitled, the suit says.
Lashi seeks damages of more than $150,000, interest, attorney fees and costs. She is represented by attorney Bruce L. Neff of Neff and Associates in Philadelphia.
U.S. District Court for the Eastern District of Pennsylvania Case number 2:16-cv-00235-JP