The COVID-19 pandemic upended every aspect of society. The disability insurance industry is no different. One of the biggest changes confronting the industry is the disability claims arising as a result of long-haul COVID symptoms. While the majority of people who contract
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The attorneys and staff of Donahue & Horrow LLP are proud to announce the firm’s 15th anniversary. In 2006, Thomas E. Donahue and Michael B. Horrow came together as founders of the firm in what, at first glance, seemed an unlikely pairing.
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Everyone at Donahue & Horrow is proud to say that we have adapted to working together during the COVID restrictions. As we approach nearly one year of working remotely or in our safe office environment, we continue to excel as a team.
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Before they were law partners, Michael and Tom were great friends for almost 15 years. Raised in two separate parts of the country, Michael in New Jersey and Tom in Nebraska, they developed almost identical, deeply embedded worldviews when it comes to
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Join Us for a Night of Comedy and Charity Come and enjoy a silent auction full of all kinds of fantastic items, a scrumptious dinner (4 great choices) and a fabulous night of comedy featuring Brad Garrett and his hand-picked special guest
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Southern California consumer attorney Michael B. Horrow will be a speaker at The Consumer Attorneys of Los Angeles (CAALA) 34th Annual Las Vegas Convention, the nation’s largest trial lawyer convention.
Southern California consumer attorney Michael B. Horrow was a guest speaker at The Consumer Attorneys of Los Angeles (CAALA) 34th Annual Las Vegas Convention, the nation’s largest trial lawyer convention. The event, which ran from Thursday, September 1 through Sunday, September 4, 2016 was held in Las Vegas and was widely attended by hundreds of attorneys.
Congratulations to Nichole D. Podgurski on being named a Rising Star by Super Lawyers for 2016. This is the forth consecutive year she has received this honor as one of the top young medical malpractice attorneys in Southern California.
For the third year in a row team Donahue & Horrow, LLP participated in the Tour de Pier. This is the fourth annual event that brings stationary cycling to the gorgeous outdoors of Manhattan Beach. Cyclists may ride for the entire five
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In 2014, a team of climbers from Donahue & Horrow LLP participated in the Aon Center fundraiser to raise awareness about lung cancer and to help fight against lung disease. Team Donahue & Horrow returned again in 2015 to climb for this
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Michael Horrow, A Los Angeles area civil litigation attorney who represents consumers who have had troubles with their insurance companies, answered questions in the members chatroom for Families of Spinal Muscular Atrophy
Donahue & Horrow sponsored an event that was held on Sunday, December 13th, featuring food, carolers, fun, and games for local families in need. Families celebrated, had a great time together, and received wrapped gifts for the holidays to take home and
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On Sunday, September 27, 2015 team members from Donahue & Horrow took part in the 7th Annual Justice Jog 5K Run/Walk in Century City to help raise critical funds for CASA, an organization that offers important programs and support for children in Los Angeles foster care.
Volunteers are the heart of Habitat for Humanity of Greater Los Angeles (Habitat LA) and each year, thousands of volunteers lend a hand to build and rehabilitate homes. We are proud to be able to take part in helping others and this year, volunteers from Donahue & Horrow helped Habitat LA ensure that homeowners in Los Angeles can live in safe, decent and affordable housing. It’s hard, but rewarding work, and being part of a team that strives to improve the lives of others is what it’s all about at Donahue & Horrow.
Many homeowner insurance policies cover additional living expenses during natural disasters. This covers living expenses for homeowners incurred as a result of damage caused by fire or mandatory evacuation, allowing consumers to focus their attention on recovery. The coverage typically includes food and housing costs, furniture rental, relocation and storage, and extra transportation expenses. Policy provisions, including deductibles, vary by company. Consumers should check with their insurer regarding any limitations that may apply to the coverage.
LOS ANGELES – September 10, 2015 – Michael B. Horrow, partner at the law firm of Donahue & Horrow LLP will be speaking at the American Conference Institute’s (ACI’s) 18th National Advanced Forum on Litigating Disability Insurance Claims to be held in Philadelphia, PA on January 21-22, 2016.
Teams from Donahue & Horrow, LLP participated in the 3rd Annual Tour de Pier. This unique fundraising event brings one of the hottest indoor fitness activities – stationary cycling – to the gorgeous outdoors of Manhattan Beach. The 2015 Tour de Pier was held on Sunday, May 17, 2015 and raised funds for the cancer community to benefit three different charities.
Below is a glossary of some of the more commonly used terms contained in, or used to describe insurance policies according to the California insurance department. This glossary is intended to provide general information only and specifically applies to California insurance matters
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Adelelmo Cabral was driving home from work on the Eastbound I-10 freeway when he lost control of his car, crossed several lanes of traffic, and collided with the rear of a Ralph’s tractor-trailer rig that had been parked on the freeway shoulder, about 16-feet from the edge of the right lane. The area where the truck had been parked was marked by CalTrans with an “Emergency Parking Only” sign. The Ralph’s driver had stopped there to have a snack. He chose that specific area because it was shaded. Michael Horrow represented Mr. Cabral’s wife and children in a wrongful-death case against Ralph’s.
At trial, Mr. Horrow obtained a jury verdict in favor of the Cabral family, which found that the Ralph’s driver had been negligent in parking his truck adjacent to the freeway, and he also persuaded the trial court to deny Ralph’s motion for judgment notwithstanding the verdict. On appeal, however, the Court of Appeal reversed the judgment in favor of the Cabral family, finding that Ralphs could not be held liable because its driver owed no duty of care to passing motorists with respect to where he parked his truck alongside the freeway.
The California Supreme Court agreed to hear the case, and reversed the Court of Appeal, reinstating the jury verdict.
An OB/GYN retained Michael Horrow to represent her in an insurance bad-faith lawsuit in federal court to challenge Provident’s denial of her claim for long-term disability benefits. As part of her bad-faith claim, Mr. Horrow served a discovery request on Provident asking it to provide information about the bonus awards and performance ratings for the employees who denied Welle’s claim. The insurer refused to provide this information, claiming that the request was improper for various reasons. Mr. Horrow challenged this position and the federal court ruled that Provident was obligated to provide the information he had requested, which the court found was relevant to the bad-faith claim and not unduly burdensome or overbroad.
Michael Horrow represented Otilia Sullivan in an ERISA action in federal court to recover long-term disability benefits. One of the disputed issues in the case was whether the district court should evaluate the plan’s denial of benefits under the de novo or the abuse-of-discretion standard of review. The plan argued that because the “Summary Plan Description” (SPD) document that it provided to plan members to summarize the plan benefits said that the abuse-of-discretion standard applied, the court should apply that standard. But Michael Horrow pointed out that, notwithstanding the statement in the SPD about the administrator having discretion, the plan itself contained no such grant of authority. Mr. Horrow convinced the district court that, in the absence of a grant of discretion in the plan document itself, a statement in the SPD to that effect was insufficient. As a result, the court applied the de novo standard of review.
April Cabana suffered back and leg injuries in an automobile accident. She succeeded in obtaining long-term disability (LTD) benefits from her employer’s disability plan, which was administered by Reliance. After the accident Cabana received extensive treatment on her back, undergoing two spinal-fusion surgeries. Yet she continued to have severe pain. Reliance agreed that she was totally disabled under the “own occupation” disability standard that applied for the first 24 months of the plan. After the 24-month period, the plan applied an “any occupation” test for total disability, and the plan continued to find that she was disabled. But roughly a year later, the plan changed its finding, found that Cabana was no longer totally disabled, and stopped paying benefits.
Cabana retained Michael Horrow to file an action in federal court under ERISA to reinstate her LTD benefits. He marshalled the evidence of her ongoing pain and medical difficulties, and convinced the district court at trial that Cabana was, in fact, totally disabled and entitled to benefits.
In 2014, a team of climbers from Donahue & Horrow, LLP participated in the Aon Center fundraiser. This year team Donahue Horrow once again stepped up to help fight against lung diseases. Each member of the team climbed 1,377 steps in a show of support for the American Lung Association’s fundraiser, Fight For Air Climb, at the Aon Center, Downtown LA on April 11, 2015.
Congratulations to Nichole D. Podgurski on being named a Rising Star by Super Lawyers and for being honored as one of the top young medical malpractice attorneys in Southern California. She also received this award in 2013.
Nichole is an associate who handles cases in all areas of the firm’s practices, including the Consumer Litigation Department, Medical Malpractice, Elder Abuse and Personal Injury.
Donahue & Horrow sponsored an event that was held on Sunday, December 14th, featuring food, fun and games for local families in need. Families celebrated, had a great time together, and received gifts for the holidays.
SACRAMENTO, Calif. – Insurance Commissioner Dave Jones announced today that his department is ready to accept insurance company filings to create new commercial coverage or endorsements to personal auto insurance policies that will provide coverage for Californians who transport passengers for Transportation Network Companies (TNCs) like Uber, Lyft and Sidecar.
On Sunday, October 26, 2014, a team of walkers from Donahue & Horrow participated in the SKECHERS Pier to Pier Friendship walk to help raise funds for the Greenberg Foundation, an organization that benefits philanthropy, voluntarism and grantmaking foundations, focusing specifically on private grantmaking foundations programs with am emphasis on serving the needs of children.
We are pleased to announce our participation in a fun, family oriented fund raising event for Court Appointed Special Advocates (CASA) Los Angeles, a volunteer-based nonprofit that provides advocacy and support to children in foster care due to abuse, neglect, abandonment, or other family issues.
Fibromyalgia can cause intense, unrelenting pain, as well as migraine headaches, irritable bowel syndrome. and even temporomandibular joint (TMJ) and muscle problems. Dealing with pain can be difficult enough, but when coupled with extreme fatigue and memory problems, it is easy to see why fibromyalgia can become a disabling condition.
Many insurance carriers, as well as government disability programs, used to treat fibromyalgia claims with great skepticism, and unless it was diagnosed with another disabling condition, more often than not was seen as a nondisabling condition. However, in July of 2012 that changed when the Social Security Administration issued a new ruling that clarified when fibromyalgia is considered a disability. Read the ruling in, “How And When Fibromyalgia Is Determined To Be A Disability By The SSA.”
SSR 12-2p: Titles II and XVI: Evaluation of Fibromyalgia – How and when the Social Security Administrations classifies fibromyalgia (FM) as a disability; diagnosis, documentation, other requirements.
At the law firm of Donahue & Horrow, LLP, we are honored to have been able to participate in the Tour de Pier fundraiser to benefit those struggling with cancer. Two teams from Donahue & Horrow led by Michael Horrow and Tom Donahue rode in place to raise money to benefit cancer charities.
Although many people think of CTS as a repetitive injury, not only is that often not the suspected cause of CTS, but recent studies seem to show a stronger link between those who have other autoimmune disorders such as diabetes, Hashimoto’s thyroiditis (a hypothyroidism disease), over activity of the pituitary gland, and rheumatoid arthritis and those afflicted with CTS. Women, especially pregnant women with edema, and women in menopause suffering from fluid retention, and overweight people are also known to have a higher risk of CTS than the general population.
On April 5, 2014, Donahue & Horrow team members participated in an American Lung Association fundraiser, Climb for Air, at the Aon Center, Downtown LA. The Aon Center is the second tallest building on the West Coast and has 63-stories which meant each team member climbed 1,377 steps!
In order to show support for the Dane Williams Foundation and to help protect children against predators, Donahue & Horrow will be attending their fundraising event, “A Night Of Comedy To Save Children.”
Donahue & Horrow, LLP has put together a team in which each member will climb 1,377 steps in a show of support for the American Lung Association’s fundraiser, Fight For Air Climb, at the Aon Center, Downtown LA on April 5, 2014.
At the law firm of Donahue & Horrow, LLP, we are honored to be sponsors of the Tour de Pier fundraiser to benefit those struggling with cancer. Two teams from Donahue & Horrow led by Michael Horrow and Tom Donahuewill be riding in place this year to raise money to benefit cancer charities.
If you live near a high risk fire area and received a non-renewal notice of your homeowners insurance, it is important to know your rights and options. While there are currently no laws in California that prohibit an insurer from non-renewing a homeowner’s insurance policy, California law does provide consumers with specific rights in the event of a non-renewal..
Congratulations to Nichole D. Podgurski on being named a Rising Star by Super Lawyers and for being honored as one of the top young medical malpractice attorneys in Southern California. The selection process is multi-phased and includes independent research, peer nominations and peer evaluations. While up to 5 percent of the lawyers in a state are named to Super Lawyers, no more than 2.5 percent are named to Rising Stars.
Prosecutors have charged more than 100 former New York City employees, including 72 police officers and eight firefighters with disability insurance fraud. It is now being estimated that since 1988 as much as $400 million has been paid out for fraudulent disability claims filed by NYC employees against Social Security Disability Insurance (SSDI).
For many years, life insurers have used the Death Master File to search for and stop payments to annuity holders, but did not use the database to identify deceased life insurance policyholders whose beneficiaries are owed life insurance proceeds. It is estimated that through this practice insurers avoided paying over a billion dollars in life insurance proceeds to beneficiaries.
October 9, 2013 California Governor Jerry Brown signed AB 1232 into law, enacting new provisions relating to disability rights. The new law strengthens the Lanterman Developmental Disabilities Services Act of 1969, a landmark disabilities law that enforces the rights of the disabled
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Allstate Insurance Company is seeking to recover $6.6 million in treble damages against 80 New York and Florida area defendants in its 4th insurance fraud lawsuit of 2013. Since 2003, Allstate has filed 48 fraud lawsuits in New York State seeking more than $237 million in damages.
“Too often, insurers have sidestepped their legal responsibility to make good on insurance policies purchased by their clients to provide peace of mind and financial security to their families,” said Chiang. “I’m pleased that these eleven companies have come forward and agreed to do what is right by their clients.”
State Controller John Chiang and Insurance Commissioner Dave Jones today announced two multi-state settlements with AIG Insurance Company that require the company to pay an estimated $25 million to $30 million owed to California beneficiaries of life insurance policies, and an $11 million settlement payment.
In an effort to address the growing problem of health insurance fraud around the state, the California Assembly recently passed bill AB 2138, which will increase the amount given to agencies responsible for investigating bad faith disability claims and other types of insurance fraud. Under the measure, the amount paid by health and disability insurers to investigate fraud would increase from 10 cents per insured person to up to 20 cents per insured. The additional funding would allow district attorneys’ offices around the state to investigate and prosecute insurance fraud cases.
The American Association for Justice (AJJ) identified the top ten worst insurance companies in America for consumers.The survey reviewed thousands of court documents and various records to compile a list of the worst insurance companies in the country. The following insurers were rated poorly for either service or bad faith …
The definition of total disability is not standard and will vary from company to company and product to product. Total disability can be defined in different ways. Generally, it can refer to total disability where one is unable to perform the substantial and material duties of your own occupation commonly referred to as “own occupation” coverage. Or, it can refer to coverage if one is unable to perform “any occupation” for which you are reasonably educated, trained or suited. This is called “any occupation” coverage.
Denied Disability Insurance Claims, Los Angeles ERISA Appeals Lawyer Disability insurance can help protect you, and your family against a sudden loss of income if you are unable to work. Unfortunately, simply having disability insurance is no guarantee that your insurance company
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A recent ruling by the Ninth U.S. Circuit Court of Appeals will help Californians who need treatment for mental health issues to get the insurance coverage that they need. The decision will hopefully help eliminate health care claim disputes for individuals struggling with depression, anorexia or other mental health issues.
In late December, Blue Shield of California settled a bad faith insurance claim with the County and City of Los Angeles, agreeing to pay $2 million for withdrawing health insurance benefits after members became ill. The health insurer came under fire for engaging in what former Los Angeles City Attorney, Rocky Delgadillo, called “post-claims underwriting.”
This fall, California passed a law outlawing “discretionary clauses” in disability and life insurance policies. Discretionary clauses allow insurers to overrule doctors’ opinions and decide that an insured is not disabled and therefore not entitled to benefits.
November 11, 2011 – A class action lawsuit recently filed in California state court alleges that insurance giant Blue Cross engaged in illegal “bait and switch” tactics while increasing annual deductibles and premiums during the middle of a deductible year. The suit claims the company violated state laws, including the Knox-Keene Act which prohibits health care plans from using misleading advertisements and deceptive coverage descriptions.
In September 2011, the California Department of Public Health (CDPH) announced administrative penalties against 12 California hospitals for failure to meet licensing requirements that the CDPH determined caused or was likely to cause serious injury or death to patients.
When these failures occur, a patient who suffered serious harm as a result may be able to make a claim against the at-fault health-care provider in a medical malpractice lawsuit.
All life insurers licensed to do business in New York are now directed to report on how many death benefits they have not paid because they did not use the official government list of deaths to promptly identify when policyholders died, the New York Insurance Department announced today. To produce this report, the Department is requiring insurers to immediately begin using reliable available data to identify when policyholders have died and death benefits are due but unpaid. Meanwhile, the Department is working on a regulation to make this requirement permanent.