Long-Haul COVID Sufferer Placed Back on Disability Claim and Awarded Attorneys’ Fees
Over the past two years, the COVID-19 pandemic has altered nearly everyone’s life. In addition to the complete disruption of day-to-day normalcy, those who contracted COVID not only had to deal with the fear of death, but also the possibility of the lingering effects of long-haul COVID, impacting the ability to return to work.
Many people trust that long-term disability insurance will protect them when an injury or illness prevents them from being able to continue working. Unfortunately, because long-haul COVID is such a new diagnosis, many insurance companies are improperly refusing to approve disability claims based on long-haul COVID related restrictions and limitations. This happened to one of Donahue & Horrow LLP’s clients, who never fully recovered after contracting COVID. The disability insurer refused to pay her claim—until our law firm got involved.
Our client was only 47 years old when she tested positive for COVID in September 2020. After undergoing intensive care and treatment, she hoped she could steadily improve and return to her pre-COVID level of functioning. However, she suffered from lingering symptoms including, but not limited to, breathing issues, low oxygen saturation, post-COVID multi-organ dysfunction, confusion, balance difficulties, incontinence, memory issues and difficulty with attention and concentration. Unfortunately, despite extensive treatment with a number of different specialists, she remained limited and unable to return to full-time work.
After filing a long-term disability claim under a disability insurance policy issued by our client’s employer and governed by ERISA, our client was only granted five months of disability benefits before her claim was unreasonably denied. Our client dutifully appealed the claim denial, as is required by ERISA before a lawsuit can be filed. However, despite extensive documentation of her long-haul COVID symptoms and related restrictions and limitations, the insurance company refused to reverse its previous decision.
After the client contacted Donahue & Horrow LLP, our firm quickly filed a lawsuit in the Central District of California’s Downtown Los Angeles courthouse. While the Court moved slowly, not issuing any case management, pre-trial or trial dates, we kept advocating for our client and convinced the insurance company to conduct a mediation while waiting for the Court to issue dates.
At the mediation, Michael Horrow, founding partner of Donahue & Horrow LLP detailed the medical evidence demonstrating that our client was unable to continue working and that there was simply no medical basis to the insurance company’s denial decision. While no settlement was reached at the mediation, shortly thereafter the insurer sent a letter indicating that it reversed its claim decision and reinstated and approved our client’s claim. Accordingly, she will receive and collect every dollar that the insurance company owes her, and the insurer will be required to pay the attorneys’ fees she was forced to incur.
If you believe that your disability insurance, life insurance or Accidental Death & Dismemberment insurance claim was improperly denied by your insurance company, call Donahue & Horrow LLP at (877) 664-5407 for a free consultation. If the denial letter from the insurance company mentions ERISA, do not delay as there are deadlines that must be met immediately or your claim will be lost forever.