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 loss of life, but additionally the opportunity of the lingering results of long-haul COVID, impacting the flexibility 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 firms 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 totally recovered after contracting COVID. The incapacity insurer refused to pay her declare—till our regulation agency acquired concerned.
Our consumer was solely 47 years outdated when she examined constructive for COVID in September 2020. After present process intensive care and therapy, she hoped she may steadily enhance and return to her pre-COVID degree 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 intensive therapy 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 below 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 intensive documentation of her long-haul COVID signs and associated restrictions and limitations, the insurance coverage firm refused to reverse its earlier choice.
After the consumer contacted Donahue & Horrow LLP, our agency shortly 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 stored advocating for our consumer and satisfied the insurance coverage firm to conduct a mediation whereas ready for the Court docket to difficulty 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 choice. Whereas no settlement was reached on the mediation, shortly thereafter the insurer despatched a letter indicating that it reversed its declare choice and reinstated and accepted our consumer’s declare. Accordingly, she is going to obtain and gather each greenback that the insurance coverage firm owes her, and the insurer can be required to pay the attorneys’ charges she was compelled to incur.
In case you imagine 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 have to be met instantly or your declare can be misplaced eternally.