Home Insurance Law Excessive Worth Lengthy-Time period Incapacity Insurance coverage Settlement

Excessive Worth Lengthy-Time period Incapacity Insurance coverage Settlement

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 total worth of the contract for our Monterey County-based consumer 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 consumer, 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 triggered low again ache, fibromyalgia in addition to extreme melancholy and nervousness. Beneath the phrases of the insurance coverage coverage, our consumer 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 incapability to carry out “any occupation.”  

Whereas the insurance coverage firm initially accredited our consumer’s declare and continued to seek out our consumer 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 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 first of the pandemic, when no corporations have been hiring – the insurance coverage firm denied her declare, stating that she might 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 evaluate. The vocational evaluate concluded that our consumer might 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 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 consumer.

In consequence, we have been in a position to safe a big lump sum cost for our consumer to safe and put money into 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.

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 immediately, and we’ll 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.

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