I’m honored to share one other story of how we helped a consumer get better the long-term incapacity (LTD) insurance coverage advantages she desperately wanted after her declare was unfairly denied. This can be a testomony to the facility of perseverance and experience in terms of preventing for our purchasers’ rights towards giant insurance coverage firms like New York Life.
Our Consumer’s Story
Our consumer labored as a Mortgage Help Assistant for Navy Federal Credit score Union till February 2022, when extreme well being issues made it unattainable for her to proceed working. She was battling liver illness, spinal stenosis with radiculopathy, carpal tunnel syndrome, neuropathy, and persistent ache. These situations precipitated vital limitations and restrictions that left her unable to carry out the duties of her job—or any job, for that matter.
Initially, our consumer’s LTD declare was accredited. Nonetheless, in July 2023, New York Life abruptly terminated her advantages, claiming there have been no restrictions or limitations stopping her from working. Their determination was primarily based closely on a file evaluate performed by a medical director specializing in neurology, who had by no means met our consumer in individual.
How We Fought Again
The claimant turned to us for assist, and we launched a full-scale enchantment of the denial. Our technique attacked the guts of New York Life’s determination:
- Exposing Cherry-Picked Proof: We confirmed how the medical director’s evaluate ignored important elements of our consumer’s medical historical past and targeted solely on data that supported the denial. This cherry-picking strategy is a typical tactic utilized by insurers, and we weren’t going to allow them to get away with it.
- Coverage Language as a Weapon: We used the insurance coverage coverage’s personal definitions of “incapacity” and “proof of loss” to argue that the claimant met their standards. This strengthened her case for continued advantages.
- Difficult “Sedentary Work” Assumptions: New York Life claimed that our consumer may carry out sedentary work with lodging resembling avoiding repetitive wrist actions. We countered this argument with medical proof that her situations rendered her unable to maintain any work setting, even one which required minimal bodily exertion.
The Turning Level
On account of our thorough enchantment, New York Life ordered an Unbiased Medical Examination (IME), during which a doctor truly examined our consumer in individual. The IME confirmed what her treating physicians had stated all alongside: her impairments had been extreme sufficient to stop her from working.
With no selection however to acknowledge the energy of our enchantment and the findings of the IME, New York Life reinstated our consumer’s long-term incapacity advantages.
The Ortiz Legislation Agency Can Attraction Your Lengthy-Time period Incapacity Denial
When you’re dealing with a denial of your long-term incapacity advantages, you don’t should undergo this overwhelming course of alone. On the Ortiz Legislation Agency, we concentrate on preventing insurance coverage firms to make sure that claimants obtain the advantages they deserve.
Name us at present at (888) 321-8131 for a free case analysis. Allow us to put our expertise and dedication to be just right for you. Collectively, we are able to develop a successful technique to get your advantages reinstated. Don’t wait—your monetary future could depend upon it.
