On the Regulation Workplace of Justin C. Frankel, P.C., we satisfaction ourselves on standing up for purchasers who’ve been wronged by highly effective insurance coverage corporations. One such case concerned a brave 61-year-old Senior Technical Architect who was combating debilitating medical situations that made it inconceivable for him to proceed working.
Earlier than hiring our agency, our shopper had already filed for Quick-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. Combating incapacitating power ache and the cognitive impression of his situations on his practical means, New York Life’s denial left him feeling deserted, till he turned to the Regulation 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 medicine delivered on to the spinal fluid to handle extreme ache.
Regardless of this exhaustive record 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 employees 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 contemplate the overwhelming cognitive calls for of this place.
New York Life’s declare dedication 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 fully unable to work in any capability. The insurer’s refusal to acknowledge the extent of his incapacity was unjust and egregious.
Our Method
Undeterred by the preliminary setback, our agency took instant 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 fastidiously reviewed his total medical historical past, consulted with further medical specialists, and ready a compelling case that highlighted the severity of his situations. Our workforce meticulously outlined how New York Life had used biased and improper ways 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 employees.
Our method was to not again down or settle for the unfair remedy our shopper had skilled. As an alternative, we pressed ahead, relentlessly advocating for his rights and making it clear that we’d proceed combating 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, actually, disabled and incapable of returning to work as a Senior Technical Architect. Their resolution to approve long-term incapacity advantages marked a major victory for our shopper, who had been left in limbo for therefore lengthy.
This final result not solely supplied our shopper with the monetary safety he wanted but in addition delivered peace of thoughts after a protracted, tough journey. The insurer’s acknowledgment of his incapacity was a hard-fought win that validated his struggles and the relentless assist of his treating docs.
A Shopper for Life
The success of this case is a testomony to our agency’s unwavering dedication to combating for the rights of those that are wronged by highly effective insurers. We have been proud to face by our shopper and be certain 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 satisfaction in realizing that our shopper can now deal with his well being and well-being, free from the stress and fear of economic insecurity.
Should you’re going through related challenges together with your long-term incapacity declare, know that we’re right here to assist. We’ve got the expertise, the assets, and the dedication to battle for the advantages you deserve.
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