Shoe Salesman Receives Six-Figure Settlement In Dispute Over Disability Insurance Benefits
A shoe salesman for major, high-end department stores received a six-figure settlement from a large disability insurance company with the help of Michael Horrow and the team at Donahue & Horrow LLP. In February 2017, our client was in a motor vehicle accident that exacerbated his previously existing neck and back issues. After a four-decade career as a salesman for major, high-end department stores, he was forced to stop working due to his escalating pain.
Our client filed a disability claim under an insurance plan provided by his employer and governed by ERISA. While it was initially approved, after about 18 months of payment, the insurance company abruptly stopped paying his claim, stating that he could return to work in his previous occupation.
After receiving the denial letter, the shoe salesman hired Donahue & Horrow LLP to help with his appeal. Our legal team successfully proved to the insurance company that our client was unable to continue working as a shoe salesman and his claim for benefits was reinstated.
Unfortunately, a few months later, the definition of disability changed—rendering the shoe salesman’s inability to perform the duties of his previous occupation insufficient to support a claim for disability benefits. . Going forward our client needed to demonstrate that his back and neck pain prevented him from performing the duties of “any occupation.” While our client provided medical records supporting his claim, the insurance company opined that he could return to work. Our client’s claim was denied once again.
Donahue & Horrow LLP handled his appeal, but this time the insurance company refused to overturn its denial decision. In response, a lawsuit was filed in the Federal Court in Los Angeles, California.
After the lawsuit was filed, the parties agreed to a mediation at which a settlement was reached. While the terms of the settlement are confidential, our client was able to receive all of the benefits that were due to him, even after factoring in attorneys’ fees and costs.
If you believe your insurance company has improperly denied your claim for disability insurance benefits, we are here to help. Call our team today for a free consultation at (877) 664-5407.