Oral Surgeon Wins Large Settlement After Disability Claim Denial

When an insurance company wrongfully denied our client’s insurance claim, Michael Horrow and his team at Donahue & Horrow LLP secured a settlement for their client after a prolonged dispute over disability insurance benefits. The case involved extensive litigation, including depositions, discovery disputes, a motion for summary judgment, multiple mediations, and an appeal to the United States Court of Appeals for the Ninth Circuit. Throughout the process, Michael Horrow remained focused on obtaining the benefits owed to his client.

Faced with this unprecedented factual scenario, Michael Horrow did not hesitate to accept the insured’s case. With his years of insurance experience, Mr. Horrow relied on a line of cases holding that, even if a person is physically capable of performing their job, if doing so puts them at risk of further disability or even death, the insured can be considered disabled and entitled to benefits.  

During litigation, Mr. Horrow exposed the insurance company’s hypocrisy by obtaining deposition testimony wherein its employees admitted that while they were telling our client that he should stare directly into the mouths of his patients and use tools that meant he was breathing in aerosolized saliva, they were working from the safety of their home to protect themselves from contracting COVID from their co-workers. Donahue & Horrow were also able to secure the testimony of experts supporting the assertion that our client was at high risk of death should he have worked during the COVID pandemic.

Unfortunately, following a motion for summary judgment filed by the insurance company, the District Court for the Eastern District of California ruled that the insurance company’s decision was proper and that, although returning to work during the pandemic could literally kill our client, he was not disabled under the terms of the policy.

Even after receiving the Court’s ruling, Michael Horrow was still convinced that his client was entitled to insurance benefits. Accordingly, he agreed to appeal the District Court’s ruling to the Ninth Circuit.  Following the briefing, the Ninth Circuit ruled that the District Court was incorrect and that our client had a valid argument that the risk of disability and death meant that he could be entitled to disability benefits, and that was an issue for a jury to decide.

Following the Ninth Circuit victory, the parties participated in mediation, which resolved the case.

This case is yet another example of Michael Horrow and Donahue & Horrow going to bat for a client, even after a Court initially ruled against them. Michael Horrow is tenacious when fighting for his clients.

If you need help fighting an insurance company, call Donahue & Horrow LLP at (877) 664-5407 for a free consultation. Donahue & Horrow is ready to fight for the benefits you deserve.