We’re thrilled to announce that after once more, we’ve got 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 Data/Detention Supervisor for the Metropolis of Monterey, grew to become disabled in June 2013 as a result of quite a lot of situations together with degenerative disc illness. This situation brought about low again ache, fibromyalgia in addition to extreme despair and anxiousness. 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 permitted 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 performed two thorough opinions however didn’t 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 had been hiring – the insurance coverage firm denied her declare, stating that she may abruptly return to work. The insurer’s choice relied on the opinion of a one-time health worker, who ignored the proof supporting incapacity and a closely flawed vocational evaluation. The vocational evaluation concluded that our shopper may return to her similar 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 Companion, Michael Horrow, satisfied the insurance coverage firm to succeed in a fast settlement with our shopper.
Consequently, we had been in a position to safe a big lump sum cost for our shopper to safe and spend money on her future well-being. Moreover, the phrases of the settlement included a provision whereby she would not need to certify her incapacity to the insurance coverage firm each month till she turned 65.
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In case your non-public incapacity insurance coverage declare was unfairly denied, contact Donahue & Horrow LLP at (877) 664-5407 in the present day, and we are going to 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.