We’re thrilled to announce that after once more, we have now secured a settlement over and above the total worth of the contract for our Monterey County-based shopper whose declare for long-term incapacity insurance coverage advantages was improperly and unfairly denied. Furthermore, Donahue & Horrow LLP was in a position to persuade the insurance coverage firm to pay the favorable settlement shortly after submitting the case with out having to take a single deposition nor file a single movement.
Our shopper, a 58-year-old Police Information/Detention Supervisor for the Metropolis of Monterey, grew to become disabled in June 2013 as a consequence of quite a lot of situations together with degenerative disc illness. This situation induced low again ache, fibromyalgia in addition to extreme melancholy and nervousness. Below the phrases of the insurance coverage coverage, our shopper initially needed to reveal that she was unable to carry out the duties of her “personal occupation,” and after two years, she needed to reveal an incapability to carry out “any occupation.”
Whereas the insurance coverage firm initially authorized our shopper’s declare and continued to seek out our shopper disabled even after the definition of incapacity modified, the insurance coverage firm appeared decided to seek out an excuse to disclaim her declare.
In 2015 and 2016, the insurer carried out two thorough opinions however did not develop proof that she may carry out the duties of any occupation given her restrictions and limitations. But that didn’t cease the insurance coverage firm from its efforts to proceed to attempt to deny the declare.
In March 2020 – at the beginning of the pandemic, when no firms have been hiring – the insurance coverage firm denied her declare, stating that she may abruptly return to work. The insurer’s determination relied on the opinion of a one-time medical expert, who ignored the proof supporting incapacity and a closely flawed vocational overview. The vocational overview concluded that our shopper may return to her identical bodily demanding pre-disability occupation that six years earlier, the insurance coverage firm discovered she couldn’t do.
After our workplace filed the lawsuit, the insurance coverage firm eliminated it to Federal Courtroom, particularly the Northern District of California, San Jose Division.
Donahue & Horrow LLP’s Founding Accomplice, Michael Horrow, satisfied the insurance coverage firm to succeed in a fast settlement with our shopper.
Because of this, we have been in a position to safe a big lump sum cost for our shopper to safe and put money into her future well-being. Moreover, the phrases of the settlement included a provision whereby she would not should certify her incapacity to the insurance coverage firm each month till she turned 65.
We Are Right here to Assist.</sturdy?
In case your non-public incapacity insurance coverage declare was unfairly denied, contact Donahue & Horrow LLP at (877) 664-5407 as we speak, and we’ll conduct a free analysis of your case. We’re right here that will help you get the non-public incapacity insurance coverage advantages you deserve and paid for.