Lawsuit Against TIAA and Tulane University for Denial of Disability Benefits (View as PDF) (Filed April 8, 1998)
CIVIL DISTRICT COURT FOR THE PARISH OF ORLEANS STATE OF LOUISIANA
NO: 98.6317 DIVISION "F" SECTION 10 DOCKET NO. DR. CARL BERNOFSKY
VERSUS
TEACHERS INSURANCE AND ANNUITY ASSOCIATION &
THE ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
FILED: __________________ ________________________
DEPUTY CLERK
PETITION FOR DAMAGES Plaintiff, Dr. Carl Bernofsky ("Bernofsky") residing at 6478 General Diaz, New Orleans, Louisiana 70124, respectfully represents: 1.Bernofsky is a person of the full age of majority, and a resident of Orleans Parish, State of Louisiana.
2.The following are made defendants herein:
- Teachers Insurance and Annuity Association, domiciled at 730 Third Avenue, New York, NY 10017, is a foreign insurer doing business in this Parish and State but not registered with either the Secretary or the Commissioner of Insurance for the State of Louisiana.
- The Administrators Of The Tulane Educational Fund, the board charged with overseeing the operation and administration of the Tulane University School of Medicine, an institution of higher learning, with certain of its board members domiciled in this Parish and State.
3.Upon information and belief, the aforesaid defendants are justly and truly indebted unto plaintiff jointly, severally, and in solido in the full and true sums that are reasonable in the premises, with legal interest on all amounts from date of judicial demand until paid, plus reasonable attorney fees and all costs of this proceeding.
4.Bernofsky was employed as a full time employee by Tulane University Medical School ("Tulane") in the State of Louisiana during the period from 1975 to April 21, 1995. During his period of employment with Tulane, he paid insurance premiums to the Teachers Insurance and Annuity Association ("Insurer") for long-term disability coverage, an insurance arrangement.
5.The premiums paid to the Insurer for long-term disability coverage were collected and forwarded by Tulane to the Insurer.
6.Bernofsky amassed a cancerous tumor measuring 8 cm x 5 cm x 3.5 cm, or 140 cc in volume. Bernofsky observed the appearance of the tumor on May 9, 1995 and immediately sought medical treatment.
7.To amass a tumor this size, a minimum of 74 days to 370 days is necessary, i.e., the onset of tumorigenesis occurred within the time frame of 2 to 10 months prior to observation, while Bernofsky was employed at Tulane.
8.Bernofsky suffered latent disablement during the development of his malignancy even though, at the time, his only physical symptom was fatigue.
9.Bernofsky was terminated from his employment with Tulane on April 21, 1995.
10.Bernofsky applied for benefits under the Insurer's group long-term disability insurance policy. He was notified by the Insurer on March 6, 1998 that his application forlong-term disability benefits was denied.
11.The policy states: "If your insurance ceases, it will not affect your benefits for a Total Disability existing on that date."
12.Upon information and belief, Tulane neither directly nor indirectly owns, controls, administers or assumes responsibility for the Insurance policy or its benefits.
13.The defendants have breached their contract of insurance with Bernofsky and wrongfully denied him coverage and benefits to which he is entitled.
WHEREFORE, Bernofsky prays that defendants be ordered to provide payment of benefits due under the Teachers Insurance and Annuity Association Group Long Term Disability Benefits Plan, together with fees pursuant to La.Rev.Stat. 22:657.
s/ Roger Phipps
Roger D. Phipps #20326PHIPPS & PHIPPS
210 Baronne Street, Suite 1410
New Orleans, Louisiana 70112
(504) 524-2298PLEASE SERVE:
- TEACHERS INSURANCE AND ANNUITY ASSOCIATION
C/O Jay Applebaum, Esq.
Teachers Insurance and Annuity Association
730 Third Avenue
New York, NY 10017
- THE ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
C/O Agent for Service of Process
Ronald Mason, Jr., Esq.
Tulane University
Uptown Campus
300 Gibson Hall
New Orleans, Louisiana 70118-5698
See Outcome
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