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Over the previous two years, the COVID-19 pandemic has altered almost everybody’s life. Along with the whole disruption of day-to-day normalcy, those that contracted COVID not solely needed to take care of the worry of demise, but additionally the potential of the lingering results of long-haul COVID, impacting the power to return to work.
Many individuals belief that long-term incapacity insurance coverage will shield them when an harm or sickness prevents them from with the ability to proceed working. Sadly, as a result of long-haul COVID is such a brand new prognosis, many insurance coverage corporations are improperly refusing to approve incapacity claims primarily based on long-haul COVID associated restrictions and limitations. This occurred to certainly one of Donahue & Horrow LLP’s shoppers, who by no means absolutely recovered after contracting COVID. The incapacity insurer refused to pay her declare—till our legislation agency received concerned.
Our consumer was solely 47 years previous when she examined optimistic for COVID in September 2020. After present process intensive care and remedy, she hoped she might steadily enhance and return to her pre-COVID stage of functioning. Nonetheless, she suffered from lingering signs together with, however not restricted to, respiration points, low oxygen saturation, post-COVID multi-organ dysfunction, confusion, stability difficulties, incontinence, reminiscence points and problem with consideration and focus. Sadly, regardless of in depth remedy with quite a few totally different specialists, she remained restricted and unable to return to full-time work.
After submitting a long-term incapacity declare beneath a incapacity insurance coverage coverage issued by our consumer’s employer and ruled by ERISA, our consumer was solely granted 5 months of incapacity advantages earlier than her declare was unreasonably denied. Our consumer dutifully appealed the declare denial, as is required by ERISA earlier than a lawsuit could be filed. Nonetheless, regardless of in depth documentation of her long-haul COVID signs and associated restrictions and limitations, the insurance coverage firm refused to reverse its earlier resolution.
After the consumer contacted Donahue & Horrow LLP, our agency rapidly filed a lawsuit within the Central District of California’s Downtown Los Angeles courthouse. Whereas the Courtroom moved slowly, not issuing any case administration, pre-trial or trial dates, we saved advocating for our consumer and satisfied the insurance coverage firm to conduct a mediation whereas ready for the Courtroom to subject dates.
On the mediation, Michael Horrow, founding associate of Donahue & Horrow LLP detailed the medical proof demonstrating that our consumer was unable to proceed working and that there was merely no medical foundation to the insurance coverage firm’s denial resolution. Whereas no settlement was reached on the mediation, shortly thereafter the insurer despatched a letter indicating that it reversed its declare resolution and reinstated and accredited our consumer’s declare. Accordingly, she’s going to obtain and accumulate each greenback that the insurance coverage firm owes her, and the insurer might be required to pay the attorneys’ charges she was pressured to incur.
In the event you consider that your incapacity insurance coverage, life insurance coverage or Unintentional Demise & Dismemberment insurance coverage declare was improperly denied by your insurance coverage firm, name Donahue & Horrow LLP at (877) 664-5407 for a free session. If the denial letter from the insurance coverage firm mentions ERISA, don’t delay as there are deadlines that should be met instantly or your declare might be misplaced ceaselessly.
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