Wednesday, September 7, 2022
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Excessive Worth Lengthy-Time period Incapacity Insurance coverage Settlement


We’re thrilled to announce that after once more, now we have secured a settlement over and above the complete 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 capable of 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, turned disabled in June 2013 on account of quite a lot of situations together with degenerative disc illness. This situation precipitated low again ache, fibromyalgia in addition to extreme despair and anxiousness. Underneath the phrases of the insurance coverage coverage, our shopper initially needed to show that she was unable to carry out the duties of her “personal occupation,” and after two years, she needed to show an incapacity to carry out “any occupation.”  

Whereas the insurance coverage firm initially accredited 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 evaluations however didn’t develop proof that she might 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 might immediately 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 assessment. The vocational assessment concluded that our shopper might 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 Court docket, 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.

In consequence, we have been capable of safe a big lump sum fee 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 right now, and we’ll conduct a free analysis of your case. We’re right here that can assist you get the non-public incapacity insurance coverage advantages you deserve and paid for.

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