We’re thrilled to announce that when once more, we’ve 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 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, grew to become disabled in June 2013 resulting from quite a lot of situations together with degenerative disc illness. This situation prompted low again ache, fibromyalgia in addition to extreme melancholy and anxiousness. Underneath the phrases of the insurance coverage coverage, our shopper initially needed to exhibit that she was unable to carry out the duties of her “personal occupation,” and after two years, she needed to exhibit an incapacity to carry out “any occupation.”
Whereas the insurance coverage firm initially authorised our shopper’s declare and continued to search out our shopper disabled even after the definition of incapacity modified, the insurance coverage firm appeared decided to search 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 – initially of the pandemic, when no firms have been hiring – the insurance coverage firm denied her declare, stating that she may out of the blue 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 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 Court docket, 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.
Consequently, we have been capable of safe a big lump sum fee 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 now 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 at present, 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.