I’m honored to share one other story of how we helped a shopper recuperate the long-term incapacity (LTD) insurance coverage advantages she desperately wanted after her declare was unfairly denied. It is a testomony to the ability of perseverance and experience in the case of preventing for our purchasers’ rights in opposition to massive insurance coverage corporations like New York Life.
Our Shopper’s Story
Our shopper labored as a Mortgage Help Assistant for Navy Federal Credit score Union till February 2022, when extreme well being issues made it unimaginable for her to proceed working. She was battling liver illness, spinal stenosis with radiculopathy, carpal tunnel syndrome, neuropathy, and continual ache. These situations induced vital limitations and restrictions that left her unable to carry out the duties of her job—or any job, for that matter.
Initially, our shopper’s LTD declare was accredited. Nevertheless, 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 overview carried out by a medical director specializing in neurology, who had by no means met our shopper in individual.
How We Fought Again
The claimant turned to us for assist, and we launched a full-scale attraction 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 overview ignored crucial elements of our shopper’s medical historical past and centered solely on information that supported the denial. This cherry-picking method is a standard 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 shopper might carry out sedentary work with lodging similar to avoiding repetitive wrist actions. We countered this argument with medical proof that her situations rendered her unable to maintain any work atmosphere, even one which required minimal bodily exertion.
The Turning Level
On account of our thorough attraction, New York Life ordered an Unbiased Medical Examination (IME), by which a doctor truly examined our shopper in individual. The IME confirmed what her treating physicians had stated all alongside: her impairments had been extreme sufficient to forestall her from working.
With no selection however to acknowledge the energy of our attraction and the findings of the IME, New York Life reinstated our shopper’s long-term incapacity advantages.
The Ortiz Regulation Agency Can Enchantment Your Lengthy-Time period Incapacity Denial
In case you’re dealing with a denial of your long-term incapacity advantages, you don’t need to undergo this overwhelming course of alone. On the Ortiz Regulation Agency, we focus on preventing insurance coverage corporations to make sure that claimants obtain the advantages they deserve.
Name us in the present day at (888) 321-8131 for a free case analysis. Allow us to put our expertise and dedication to give you the results you want. Collectively, we will develop a successful technique to get your advantages reinstated. Don’t wait—your monetary future could rely on it.
