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 when 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 Information/Detention Supervisor for the Metropolis of Monterey, grew to become disabled in June 2013 on account of a wide range of circumstances together with degenerative disc illness. This situation prompted low again ache, fibromyalgia in addition to extreme melancholy and nervousness. Underneath the phrases of the insurance coverage coverage, our consumer initially needed to reveal that she was unable to carry out the duties of her “personal occupation,” and after two years, she needed to reveal an incapacity to carry out “any occupation.”  

Whereas the insurance coverage firm initially authorized our consumer’s declare and continued to search out our consumer 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 carried out two thorough critiques however did not 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 – at first of the pandemic, when no corporations had been hiring – the insurance coverage firm denied her declare, stating that she may all of the sudden return to work. The insurer’s choice 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 consumer may 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 Associate, Michael Horrow, satisfied the insurance coverage firm to achieve a fast settlement with our consumer.

Because of this, we had been in a position to safe a big lump sum cost for our consumer to safe and spend money on her future well-being.  Moreover, the phrases of the settlement included a provision whereby she would not must certify her incapacity to the insurance coverage firm each month till she turned 65.

We Are Right here to Assist.</sturdy? 

In case your personal incapacity insurance coverage declare was unfairly denied, contact Donahue & Horrow LLP at (877) 664-5407 immediately, and we are going to conduct a free analysis of your case. We’re right here that will help you get the personal incapacity insurance coverage advantages you deserve and paid for.

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