When Guardian Life abruptly terminated one among our shopper’s long-term incapacity (LTD) advantages, we knew we had a battle on our fingers. Her case illustrates the significance of difficult insurers who unfairly deny claims primarily based on profit limitations for psychological and nervous situations—and why having skilled authorized illustration could make all of the distinction.
Our Consumer’s Story
For two years, our shopper obtained LTD advantages from Guardian resulting from her incapacity to work. Nevertheless, Guardian determined to terminate her advantages, citing a 24-month restrict (or most advantages payable below the coverage) for psychological well being situations. They claimed that her PTSD and ADHD have been the only real foundation for her incapacity, regardless of her intensive historical past of significant bodily situations, together with:
Having conveniently ignored her vital bodily impairments, it was clear to us that Guardian’s determination was unjustified.
Our Enchantment Technique
We used our years of expertise to put together an attraction sturdy sufficient to problem Guardian’s denial. Right here’s how we approached the method:
- Specializing in Bodily Impairments: We demonstrated that our shopper’s bodily situations—not simply her psychological well being diagnoses—have been independently disabling. By submitting intensive medical information, we left little question that her bodily limitations prevented her from performing even sedentary work.
- Uncovered Flaws in Guardian’s Analysis: We fastidiously analyzed Guardian’s determination and identified its errors, together with its failure to think about the total extent of our shopper’s impairments and its reliance on outdated or incomplete medical opinions.
- Using Knowledgeable Testimony: We labored along with her treating physicians and different specialists to acquire compelling medical opinions and vocational proof demonstrating her incapacity to return to work in any capability.
Our Outcomes
In gentle of the overwhelming proof we introduced, Guardian reversed its determination and reinstated our shopper’s long-term incapacity advantages. This victory ensured that she would proceed to obtain the monetary assist she wanted to concentrate on her well being and well-being. We recovered almost 5 figures in overdue advantages and the potential for over $100,000 in future advantages.
Don’t Let a Lengthy-Time period Incapacity Denial Take Away Your Monetary Safety
In case your long-term incapacity advantages have been denied or terminated, you don’t have to simply accept the insurance coverage firm’s determination. On the Ortiz Regulation Agency, we’ve the expertise and information to tackle even the most important insurers and can battle for the advantages you deserve.
Contact us on-line or name us at present at (888) 321-8131 for a free case analysis. Don’t wait—your monetary stability and peace of thoughts are too vital to go away within the fingers of an insurance coverage firm. Allow us to aid you battle again.
