Lessons From a Leader in Disability Insurance Law

Lessons in Disability Insurance

  • NEVER give up because your employer tells you your right to make a claim has passed;  and

  • There is no better feeling for a Plaintiff’s attorney then helping a deserving client when they didn’t even know they had a right to make a claim!

Quick (or not so quick) Story, which provides a couple of lessons.

A very nice woman called our office to inquire if we could assist her husband, who had been diagnosed with Early Onset Dementia, obtain home health benefits from Medicare.  Unfortunately, Medicare claims are outside our firm’s bailiwick.   However, her family situation was so tragic, I felt compelled to call her myself and explain why we couldn’t assist her.  While talking to her, I learned that her husband had been a Dean of Students at a California University for more than 10 years.  In his last year of employment, his skills rapidly, and inexplicably declined.

He was terminated.

Several months AFTER his termination, he was diagnosed with Early Onset Dementia.  I inquired if she had had any problem obtaining his Long Term Disability Insurance benefits, and his continued Life Insurance coverage.  She replied that when she received the diagnosis, she called the University, and was told that because he hadn’t received his diagnosis until months after he was terminated, he wasn’t permitted to either make a claim for his LTD benefits, or to continue his Life Insurance.

Of course, knowing that wasn’t true, bells went off in my head.  I advised the nice lady that she had been misinformed, and that she was almost certainly entitled to receive all of the benefits associated with his becoming ill.  It is likely that I frightened the lady with my confident statements, as she immediately inquired if she needed to pay our firm “in advance” for me to help her.  Of course, we never take advance payment, and I advised her that we only received payment if we were successful in getting the insurance company to pay her husband’s claims.  While still a bit skeptical, she agreed to let us help.

Over the next several months, after obtaining the appropriate information from her husband’s doctors, employers, and his insurance company, we were able to give the great news that the insurance company had agreed to pay ALL Long Term Disability benefits, and continue ALL of his Life Insurance in force with no premiums required.   Our client was, of course, ecstatic.

As an attorney who only represents insureds, this case and its outcome was particularly satisfying to me.   The client didn’t know she had a claim, and in fact had been misled as to her rights.   She was calling for help about an entirely different issue.  By taking an interest in her story, I was able to delve into the facts, and figure out that not only had she been given incorrect information, but that it was not too late for me to take the necessary steps to fix the problem, and obtain benefits she desperately needed to support her seriously ill husband.

Lastly, giving some credit to the insurance company, when it was presented with all of the facts, it did not fight the claim, but agreed her husband was entitled to the benefits.

So, you can see how the lessons stated above are applicable.   Never give up just because an employer tells you your time to make a claim has passed, and LISTENING to potential clients can sometimes lead to unexpected, and great results.

If you have questions about Life, Health, or Long Term Disability Benefits for your or a loved one, please call Kantor & Kantor for a free consultation at 888-569-6013 or use our online contact form.

 

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