Thursday, September 8, 2022
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Denied Lengthy-Time period Incapacity Advantages Trial Victory


An Oakland-based Household Apply physician was denied the long-term incapacity advantages that had been promised by way of an ERISA plan issued by her employer and insured by Unum Life Insurance coverage Firm of America. Nonetheless, she acted rapidly and introduced within the skilled group of incapacity legal professionals at Donahue & Horrow LLP to battle for her. Proudly, we secured a trial victory on her behalf.

Our consumer suffered from Power Migraine Dysfunction and different circumstances that rendered her unable to carry out the duties of her job.  Unum didn’t dispute that our consumer was disabled, however quite, asserted that she had not been working sufficient hours per week to qualify for advantages underneath the ERISA plan.  Nonetheless, an additional investigation performed by the Donahue & Horrow LLP group, revealed that her employment file contained ample proof that she was working 30 hours every week previous to her incapacity, clearly outlining that she was eligible for protection underneath her employer’s long-term incapacity coverage.  Nonetheless, regardless of this overwhelming proof, Unum continued to disclaim our consumer’s declare for advantages.  

On behalf of our consumer, Donahue & Horrow LLP sued Unum in Federal Courtroom, alleging that the choice to disclaim the declare for advantages was faulty 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 Courtroom dominated in favor of our consumer.  Decide Rogers defined that Unum’s denial choice was faulty as a result of – as we argued – the plain language of the Plan solely required that the doctor is working no less than 30 hours per week to be thought-about in “energetic employment” and that she submitted dependable proof that she was, in reality, working no less than 30 hours per week previous to her incapacity.  

Unum has appealed the choice to the Ninth Circuit and Donahue & Horrow LLP continues to battle relentlessly for the incapacity advantages our consumer was promised and owed. Be taught extra about our strategy to long-term incapacity insurance coverage denial.

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 anyway. Name our group at this time to be taught extra (877) 664-5407.

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