On the Legislation Workplace of Justin C. Frankel, P.C., we pleasure ourselves on standing up for shoppers who’ve been wronged by highly effective insurance coverage firms. One such case concerned a brave 61-year-old Senior Technical Architect who was fighting debilitating medical situations that made it unattainable for him to proceed working.
Earlier than hiring our agency, our shopper had already filed for Brief-Time period Incapacity advantages with New York Life however was devastated when his declare was denied. The insurer argued that he was able to performing work in a “sedentary” capability regardless of his lengthy historical past of power, extreme medical situations. Scuffling with incapacitating power ache and the cognitive influence of his situations on his practical capability, New York Life’s denial left him feeling deserted, till he turned to the Legislation Workplace of Justin C. Frankel for assist.
The Challenges
Our shopper’s medical historical past was nothing in need of overwhelming affected by a number of co-morbid spinal situations together with, power lumbar radiculopathy, lumbar herniated discs, lumbar spondylosis, foraminal stenosis, degenerative disc illness, power ache, and failed again surgical procedure syndrome. Together with three spinal surgical procedures together with multilevel discectomy, laminectomy, foraminectomy, and implantation of an intrathecal ache pump, having ache treatment delivered on to the spinal fluid to handle extreme ache.
Regardless of this exhaustive listing of debilitating situations, which included a number of main surgical procedures and power, intractable ache, New York Life refused to acknowledge the severity of our shopper’s incapacity. The insurer’s in-house medical workers and paid consultants repeatedly opined that he was able to returning to his sedentary occupation as a Senior IT Architect, unwilling to just accept or think about the overwhelming cognitive calls for of this place.
New York Life’s declare willpower was not solely medically unfounded, however it was additionally made in direct contradiction to the opinions of our shopper’s long-standing treating ache specialist, who steadfastly supported his declare and confirmed that his situation rendered him utterly unable to work in any capability. The insurer’s refusal to acknowledge the extent of his incapacity was unjust and egregious.
Our Strategy
Undeterred by the preliminary setback, our agency took rapid motion to problem New York Life’s wrongful denial. We knew that our shopper was entitled to each short-term and long-term incapacity advantages, and we have been decided to safe these advantages for him.
We rigorously reviewed his whole medical historical past, consulted with further medical consultants, and ready a compelling case that highlighted the severity of his situations. Our staff meticulously outlined how New York Life had used biased and improper techniques to dismiss the legitimacy of his incapacity. We uncovered their arbitrary and capricious decision-making course of, the place they ignored the opinions of treating physicians and relied on flawed, one-sided assessments from their paid consultants and in-house vocational workers.
Our method was to not again down or settle for the unfair remedy our shopper had skilled. As a substitute, we pressed ahead, relentlessly advocating for his rights and making it clear that we’d proceed preventing till we had secured the advantages he rightfully deserved.
Victory: Lengthy-Time period Incapacity Advantages Secured
After an intense and protracted battle, New York Life lastly relented. The insurance coverage firm acknowledged that our shopper was, in actual fact, disabled and incapable of returning to work as a Senior Technical Architect. Their choice to approve long-term incapacity advantages marked a major victory for our shopper, who had been left in limbo for thus lengthy.
This end result not solely supplied our shopper with the monetary safety he wanted but in addition delivered peace of thoughts after an extended, troublesome journey. The insurer’s acknowledgment of his incapacity was a hard-fought win that validated his struggles and the relentless help of his treating medical doctors.
A Consumer for Life
The success of this case is a testomony to our agency’s unwavering dedication to preventing for the rights of those that are wronged by highly effective insurers. We have been proud to face by our shopper and make sure that he obtained the compensation he was entitled to. This victory represents greater than only a monetary win—it was a victory for justice, for equity, and for the dignity of our shopper.
On the finish of the day, we take pleasure in realizing that our shopper can now give attention to his well being and well-being, free from the stress and fear of monetary insecurity.
If you happen to’re dealing with comparable challenges together with your long-term incapacity declare, know that we’re right here to assist. Now we have the expertise, the sources, and the willpower to struggle for the advantages you deserve.
