A shoe salesman for main, high-end malls acquired a six-figure settlement from a big incapacity insurance coverage firm with the assistance of Michael Horrow and the crew at Donahue & Horrow LLP. In February 2017, our consumer 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 malls, he was compelled to cease working as a consequence of his escalating ache.
Our consumer filed a incapacity declare below an insurance coverage plan supplied by his employer and ruled by ERISA. Whereas it was initially permitted, after about 18 months of fee, 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 enchantment. Our authorized crew efficiently proved to the insurance coverage firm that our consumer was unable to proceed working as a shoe salesman and his declare for advantages was reinstated.
Sadly, a number of 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 consumer wanted to reveal that his again and neck ache prevented him from performing the duties of “any occupation.” Whereas our consumer supplied medical data supporting his declare, the insurance coverage firm opined that he might return to work. Our consumer’s declare was denied as soon as once more.
Donahue & Horrow LLP dealt with his enchantment, however this time the insurance coverage firm refused to overturn its denial choice. 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 consumer was in a position to obtain all the advantages that have been as a consequence of him, even after factoring in attorneys’ charges and prices.
If you happen to imagine your insurance coverage firm has improperly denied your declare for incapacity insurance coverage advantages, we’re right here to assist. Name our crew at the moment for a free session at (877) 664-5407.
