A shoe salesman for main, high-end department shops acquired a six-figure settlement from a big incapacity insurance coverage firm with the assistance of Michael Horrow and the group at Donahue & Horrow LLP. In February 2017, our shopper was in a motorized vehicle accident that exacerbated his beforehand present neck and again points. After a four-decade profession as a salesman for main, high-end department shops, he was pressured to cease working attributable to his escalating ache.
Our shopper filed a incapacity declare underneath an insurance coverage plan supplied by his employer and ruled by ERISA. Whereas it was initially authorised, after about 18 months of cost, the insurance coverage firm abruptly stopped paying his declare, stating that he might return to work in his earlier occupation.
After receiving the denial letter, the shoe salesman employed Donahue & Horrow LLP to assist along with his attraction. Our authorized group efficiently proved to the insurance coverage firm that our shopper was unable to proceed working as a shoe salesman and his declare for advantages was reinstated.
Sadly, just a few months later, the definition of incapacity modified—rendering the shoe salesman’s incapability to carry out the duties of his earlier occupation inadequate to assist a declare for incapacity advantages. . Going ahead our shopper wanted to show that his again and neck ache prevented him from performing the duties of “any occupation.” Whereas our shopper supplied medical information supporting his declare, the insurance coverage firm opined that he might return to work. Our shopper’s declare was denied as soon as once more.
Donahue & Horrow LLP dealt with his attraction, however this time the insurance coverage firm refused to overturn its denial determination. In response, a lawsuit was filed within the Federal Courtroom in Los Angeles, California.
After the lawsuit was filed, the events agreed to a mediation at which a settlement was reached. Whereas the phrases of the settlement are confidential, our shopper was in a position to obtain all the advantages that have been attributable to him, even after factoring in attorneys’ charges and prices.
If you happen to consider your insurance coverage firm has improperly denied your declare for incapacity insurance coverage advantages, we’re right here to assist. Name our group right now for a free session at (877) 664-5407.