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February 2019 Archives

Private disability claims are often denied

There is a great disparity in how people think about insurance. Many Florida residents think of it as a necessary evil and purchase the minimum required for specific purposes, while others seek to protect themselves against risk by acquiring upgraded and broader coverage. For example, it is not uncommon for relatively young individuals to buy life insurance, yet, statistically, a disabling injury or illness is far more likely than an early death. However, when it comes to collecting on a filed claim, disability insurers often delay, offer low settlements, or deny the claim altogether.

Liberty Insurance forced by Court to pay LTD Benefits for Anxiety and Bipolar Disorders

In May 2015, Wells Fargo & Company (Wells) hired Rosa Ramirez as a Financial Crimes Specialist. Shortly thereafter, in August 2016, Ms. Ramirez stopped working at Wells after suffering a mental breakdown following an altercation with her manager. Thereafter, due to her worsening depression and anxiety since starting her new job, Ms. Ramirez applied for short-term disability benefits and in September 2105, Liberty Life Assurance Company of Boston (Liberty) approved her claim. Later in December 2015, Ms. Ramirez was diagnosed with Bipolar Disorder, Post-Traumatic Stress disorder, Anxiety and Major Depressive Disorder. Additionally, her treating physician opined that she required a high level of care given the severity and chronicity of her mental illness. Accordingly, Ms. Ramirez was referred to Daymark Recovery Services (Daymark). Shortly thereafter, Ms. Ramirez had her initial assessment and despite some initial improvement Ms. Ramirez regressed and under her doctor's recommendation, filed a claim with Liberty for long-term disability benefits (LTD benefits) and was approved in March 2016. In May 2016, however, Ms. Ramirez' condition worsened as she began to experience violent thoughts and act abnormally. Accordingly, Liberty re-reviewed Ms. Ramirez' claim and extended her disability benefits through July 31, 2016 because she was unable to perform nothing more than activities of daily living. In August 2016, Ms. Ramirez' doctor completed Liberty's restriction form due to her condition.

A disability insurance claim denial need not be the last word

Having insurance coverage can provide peace of mind. The hope, of course, is to never have reason to file a claim, but the expectation is that if a loss occurs, the insurance company will respond in a timely manner, address the issue professionally and pay an appropriate settlement amount to cover the damages incurred. However, when it comes to disability insurance claims, many Florida claimants find that the reality of how the insurance company handles the matter is far different from their expectations.

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