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 cope with the concern 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 defend them when an damage 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 based mostly on long-haul COVID associated restrictions and limitations. This occurred to one in every of Donahue & Horrow LLP’s purchasers, who by no means absolutely recovered after contracting COVID. The incapacity insurer refused to pay her declare—till our legislation agency bought concerned.
Our shopper was solely 47 years previous when she examined constructive for COVID in September 2020. After present process intensive care and remedy, she hoped she may steadily enhance and return to her pre-COVID degree of functioning. Nevertheless, she suffered from lingering signs together with, however not restricted to, respiration points, low oxygen saturation, post-COVID multi-organ dysfunction, confusion, steadiness difficulties, incontinence, reminiscence points and problem with consideration and focus. Sadly, regardless of intensive remedy with quite a few completely different specialists, she remained restricted and unable to return to full-time work.
After submitting a long-term incapacity declare underneath a incapacity insurance coverage coverage issued by our shopper’s employer and ruled by ERISA, our shopper was solely granted 5 months of incapacity advantages earlier than her declare was unreasonably denied. Our shopper dutifully appealed the declare denial, as is required by ERISA earlier than a lawsuit could be filed. Nevertheless, regardless of intensive documentation of her long-haul COVID signs and associated restrictions and limitations, the insurance coverage firm refused to reverse its earlier determination.
After the shopper contacted Donahue & Horrow LLP, our agency rapidly filed a lawsuit within the Central District of California’s Downtown Los Angeles courthouse. Whereas the Court docket moved slowly, not issuing any case administration, pre-trial or trial dates, we saved advocating for our shopper and satisfied the insurance coverage firm to conduct a mediation whereas ready for the Court docket to concern dates.
On the mediation, Michael Horrow, founding companion of Donahue & Horrow LLP detailed the medical proof demonstrating that our shopper was unable to proceed working and that there was merely no medical foundation to the insurance coverage firm’s denial determination. Whereas no settlement was reached on the mediation, shortly thereafter the insurer despatched a letter indicating that it reversed its declare determination and reinstated and authorised our shopper’s declare. Accordingly, she’s going to obtain and gather each greenback that the insurance coverage firm owes her, and the insurer will probably be required to pay the attorneys’ charges she was compelled to incur.
When you imagine that your incapacity insurance coverage, life insurance coverage or Unintended 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 have to be met instantly or your declare will probably be misplaced endlessly.