Insurance

The COVID-19 pandemic upended the entire world.  A large part of that disruption was the shift toward working from home instead of going to places of business.  Of course, not every person’s job allowed them to work from home.  That shift affected health care professionals whose jobs typically required not only face-to-face contact with their patients, but also specialized equipment to perform their job duties.  

Additionally, those who had been diagnosed with a myriad of immuno-compromised diseases prior to the pandemic were at a heightened risk of severe symptoms and death if they contracted COVID.  For those individuals, even returning to work wearing masks and other personal protective equipment still put them at an increased risk of contracting the potentially deadly virus.

When your medical condition prevents you from working, you would expect that your private disability insurance company would provide the benefits you paid for and were promised.  After all, the purpose of purchasing disability insurance is to protect your income if you are unable to perform your occupation.  While you may not have envisioned a global pandemic would prevent you from being able to work, that does not mean that you are not entitled to disability benefits when it happens.

Recently, Donahue & Horrow LLP filed a lawsuit in Kern County on behalf of an oral surgeon after Paul Revere Life Insurance Company (a subsidiary of Unum Life Insurance Company) improperly denied a claim for disability insurance and business overhead expense benefits.

Prior to the pandemic, our client was diagnosed with a variety of conditions, including asthma and hypertension, which, with the onset of the pandemic in March 2020, put him at considerable and unacceptable risk of death should he contract COVID-19.  His treating physician confirmed that he was a “high risk individual due to age and labile extrinsic asthma.”  As an oral surgeon, his risk of contracting COVID-19 while working was much higher than that of a typical individual; a risk further exacerbated by an inability to obtain the PPE necessary to mitigate his exposure.  Then, in August 2020, the client suffered a pulmonary embolism, further rendering him unable to continue working.  

Unfortunately, Paul Revere denied the claim in his occupation he made on his individual disability and business overhead expense policies.  The insurance company disregarded the fact that due to his underlying medical conditions the COVID-19 pandemic prevented him from performing his occupational duties “with reasonable continuity … in the usual and customary way,” thus entitling him to benefits.

When the disability insurer failed to honor the terms of the insurance policies, Donahue & Horrow LLP filed a lawsuit alleging breach of contract and breach of the implied covenant of good faith and fair dealing.  The case is currently pending in Federal Court, in the Eastern District of California.

If you were prevented from going to work due to the higher-than-normal risk posed by COVID-19, Call (877) 664-5407 to schedule your FREE CONSULTATION today. You will not pay a single out-of-pocket expense for your claim, and we will not get paid until you win. We are here to relentlessly fight for you.