An Oakland-based Household Follow physician was denied the long-term incapacity advantages that had been promised by an ERISA plan issued by her employer and insured by Unum Life Insurance coverage Firm of America. Nonetheless, she acted shortly and introduced within the skilled crew of incapacity attorneys at Donahue & Horrow LLP to combat for her. Proudly, we secured a trial victory on her behalf.
Our shopper suffered from Continual Migraine Dysfunction and different situations that rendered her unable to carry out the duties of her job. Unum didn’t dispute that our shopper was disabled, however quite, asserted that she had not been working sufficient hours per week to qualify for advantages beneath the ERISA plan. Nonetheless, an additional investigation carried out by the Donahue & Horrow LLP crew, revealed that her employment file contained ample proof that she was working 30 hours per week previous to her incapacity, clearly outlining that she was eligible for protection beneath her employer’s long-term incapacity coverage. Nonetheless, regardless of this overwhelming proof, Unum continued to disclaim our shopper’s declare for advantages.
On behalf of our shopper, Donahue & Horrow LLP sued Unum in Federal Court docket, alleging that the choice to disclaim the declare for advantages was misguided and violated the plain phrases of her Plan. Following trial briefing and a bench trial earlier than United States District Decide, Yvonne Gonzalez Rogers, the Court docket dominated in favor of our shopper. Decide Rogers defined that Unum’s denial determination was misguided as a result of – as we argued – the plain language of the Plan solely required that the doctor is working a minimum of 30 hours per week to be thought-about in “lively employment” and that she submitted dependable proof that she was, actually, working a minimum of 30 hours per week previous to her incapacity.
Unum has appealed the choice to the Ninth Circuit and Donahue & Horrow LLP continues to combat relentlessly for the incapacity advantages our shopper was promised and owed. Be taught extra about our strategy to long-term incapacity insurance coverage denial.
If in case you have a long-term incapacity coverage and are contemplating making a declare or have had your declare denied, we’re right here to assist. There are not any out-of-pocket bills for you in any respect. Name our crew at present to study extra (877) 664-5407.