An Oakland-based Household Apply physician was denied the long-term incapacity advantages that had been promised via an ERISA plan issued by her employer and insured by Unum Life Insurance coverage Firm of America. Nonetheless, she acted rapidly and introduced within the skilled workforce of incapacity attorneys at Donahue & Horrow LLP to battle for her. Proudly, we secured a trial victory on her behalf.
Our consumer suffered from Power Migraine Dysfunction and different situations that rendered her unable to carry out the duties of her job. Unum didn’t dispute that our consumer was disabled, however relatively, asserted that she had not been working sufficient hours per week to qualify for advantages underneath the ERISA plan. Nonetheless, an additional investigation carried out by the Donahue & Horrow LLP workforce, revealed that her employment file contained ample proof that she was working 30 hours per week previous to her incapacity, clearly outlining that she was eligible for protection underneath her employer’s long-term incapacity coverage. Nonetheless, regardless of this overwhelming proof, Unum continued to disclaim our consumer’s declare for advantages.
On behalf of our consumer, Donahue & Horrow LLP sued Unum in Federal Court docket, alleging that the choice to disclaim the declare for advantages was misguided and violated the plain phrases of her Plan. Following trial briefing and a bench trial earlier than United States District Choose, Yvonne Gonzalez Rogers, the Court docket dominated in favor of our consumer. Choose Rogers defined that Unum’s denial choice was misguided as a result of – as we argued – the plain language of the Plan solely required that the doctor is working not less than 30 hours per week to be thought-about in “energetic employment” and that she submitted dependable proof that she was, the truth is, working not less than 30 hours per week previous to her incapacity.
Unum has appealed the choice to the Ninth Circuit and Donahue & Horrow LLP continues to battle relentlessly for the incapacity advantages our consumer was promised and owed. Be taught extra about our strategy to long-term incapacity insurance coverage denial.
If in case you have a long-term incapacity coverage and are contemplating making a declare or have had your declare denied, we’re right here to assist. There aren’t any out-of-pocket bills for you in any way. Name our workforce as we speak to be taught extra (877) 664-5407.
