Intent to Appeal Is Not an Appeal: S.D. Texas Grants Summary Judgment for Prudential on Exhaustion Grounds

In Ellis-Young v. The Prudential Insurance Company of America, No. H-26-321, 2026 WL 1075158 (S.D. Tex. Apr. 21, 2026), Senior United States District Judge Lee H. Rosenthal granted summary judgment in favor of Prudential, holding that Plaintiff failed to exhaust her ERISA administrative remedies because she never submitted a timely appeal of Prudential’s denial of her long-term disability benefits.

Background

Plaintiff held a long-term disability policy through her employment at JPMorgan Chase, administered by Prudential. Prudential approved benefits from May 12, 2022 through January 31, 2023, then terminated them on February 3, 2023, advising Plaintiff she had 180 days to appeal. Due to the COVID-19 National Emergency, the 180-day appeal period was tolled and ran from the later of 60 days after the end of the declared emergency or one year from the denial letter date. With the National Emergency ending May 11, 2023, Plaintiff’s appeal deadline was January 6, 2024 (or January 8, 2024, tolled to Monday).

The Letters

On February 13, 2023, Plaintiff sent a letter to Prudential stating she “will be filing an appeal” and requesting her complete claim file so that she could prepare one. On February 22, 2023, Plaintiff’s counsel followed with a letter providing “legal notice of Mrs. Sherri Ellis-Young’s intent to appeal” and requesting 180 days from the denial date to complete development of the administrative record. Prudential acknowledged receipt of the file request and sent the claim file in February 2023, then again in June 2023 after counsel reported not receiving it.

No substantive appeal was ever submitted within the deadline. On January 5, 2024, counsel requested an update, at which point Prudential confirmed it had received no appeal. Plaintiff’s counsel did not submit a letter brief with attached medical records until September 16, 2025, well over a year after the appeal deadline had passed.

The Court’s Analysis

The court found the case indistinguishable from the Fifth Circuit’s controlling decisions in Holmes v. Proctor & Gamble Disability Benefit Plan, 228 F. App’x 377 (5th Cir. 2007), and Swanson v. Hearst Corp. Long Term Disability Plan, 586 F.3d 1016 (5th Cir. 2009). Both cases established that an expression of intent to appeal is not an appeal. The court identified four dispositive parallels: each letter expressed only a future intent to appeal; Plaintiff repeatedly requested additional information in order to file a proper appeal rather than submitting one; Prudential explicitly communicated that it had received only an intent to appeal, not an actual appeal; and Plaintiff submitted no factual or substantive arguments or supporting medical evidence until September 2025.

The court also rejected Plaintiff’s argument that Prudential should be estopped from enforcing the exhaustion requirement. Drawing again on Swanson, the court explained that estoppel requires a showing that plan officials affirmatively misled the claimant and sent her “on a wild goose chase” that extinguished her appeal rights. Here, Prudential timely notified Plaintiff of the 180-day deadline, provided her claim file within the appeal period, and twice informed her that it had not received a valid appeal. There was no provision of the plan or applicable law requiring Prudential to send additional warnings before the deadline expired.

Disposition

The court granted Prudential’s motion for judgment on the pleadings, construed as a motion for summary judgment under Fed. R. Civ. P. 12(d), and entered final judgment in Prudential’s favor.

What Claimants Should Know

A letter telling the insurer you plan to appeal is not an appeal. A court may dismiss your case entirely because letters expressing only an intent to appeal and requesting the claim file to prepare an appeal does not constitute an actual appeal.

Claimants must submit a substantive appeal within the deadline: one that states the reasons for disagreement and includes supporting medical evidence. Waiting on the claim file, reserving rights, or asking for more time does not stop the clock. If the deadline is at risk, file something substantive first and supplement later.