A Few Of Our Successes
Disability Insurance Law Group has a proven track record of success
both in and out of the courtroom. We have successfully appealed and/or the great majority of our cases and have
collected millions of dollars in insurance benefits for our clients. Our team is highly regarded and well-known for our
many victories at the federal district and appellate court levels as well as for our high success rate in overturning
wrongfully delayed or denied insurance claims prior to litigation.
Prudential Long Term Care Denial overturned after Appeal by DI Law Group
After breaking her hip and having surgery, Ms. ES struggled to handle the basic activities of daily living. Her family assisted her as much as possible, but finally realized that Ms. ES required regular care to make sure she could safely bathe, dress, and get around. Confident that her medical records sufficiently showed that Ms. ES was struggling and required substantial assistance with at least two Activities of Daily Living, her daughter filed a claim for long term care benefits with Prudential.
Prudential initiated the claim but then dragged its feet, constantly requesting more information and refusing to make a decision. A Nurse was sent to Ms. ES’s home per Prudential’s request and the “Assessment” was cursory and clearly not objective. Ms. ES was asked basic questions about her abilities, and her limitations were not truly tested. Based on Prudential’s review of only some of Ms. ES’s medical records and the vague and incomplete Nurse Assessment report, benefits were denied.
Ms. ES’s family hired DI Law Group to Appeal. Familiar with Prudential’s denial tactics and tendency to only partially review a claim, we insisted that Prudential schedule another Nurse Assessment. We submitted medical records, statements from her doctors, home health care workers, and family which clearly stated why Ms. ES required long term care assistance and qualified for home health care benefits. Given the new information, Prudential agreed to a second Nurse Assessment with the understanding that a member of Ms. ES’s family and one of our attorneys would be in attendance.
However, after having an independent medical consultant review our Appeal and the proof submitted, Prudential canceled the Nurse Assessment and the denial was overturned. We continue to make sure that Prudential timely pays the home health care workers as required under the terms of Ms. ES’s LTC Policy with Prudential.
Mutual of Omaha Long Term Care Denial of Alzheimer’s Insured overturned after Appeal by DI Law Group
Ms. AP was referred to DI Law Group by her neurologist after learning that she was denied long term care benefits by Mutual of Omaha. Ms. AP started showing obvious signs of dementia in January 2022 and by July of that year clearly required assistance to ensure her safety and wellbeing. Ms. AP’s family moved her into an Assisted Living Care Facility at her doctor’s recommendation and because they feared what would happen if she did not have constant supervision.
The family submitted medical records which confirmed that Ms. AP had Alzheimer’s disease and a letter from her doctor stating that she needed to be moved into a LTC facility for her own safety. Mutual of Omaha reviewed the medical records and their own notes show that they found evidence of moderate to severe dementia. Despite what seemed like obvious proof of the need for care, Mutual of Omaha’s in-house medical reviewer claimed there was not sufficient medical proof to confirm that her dementia/Alzheimer’s required “substantial supervision” and recommended that Mutual of Omaha send a nurse to Ms. AP’s home. The nurse sat with Ms. AP for a few minutes and even documented that Ms. AP did not know the date, year, day of the week or month that they were in. She chose not to ask Ms. AP to count backwards by 7s (a typical test of cognitive decline), but instead asked her to spell a simple word backwards. Although Ms. AP struggled to do so, she was finally able to get it right. The Nurse Assessment report misrepresented what occurred during the Assessment and concluded that Ms. AP did not qualify for benefits. Based on that, her claim was denied.
DI Law Group was hired to Appeal the LTC Denial. After reviewing the claim file, we obtained a detailed statement from Ms. AP’s neurologist explaining the extent of her dementia related issues and medical proof that she had dementia. We also got updated medical reports and statements from her primary care physician and statements from some of the caregivers in the ALF who attested to Ms. AP’s need for substantial supervision. Finally, we asked family members to submit testimonial statement with their observations and concerns.
Within a few weeks of receiving the Appeal, Mutual of Omaha contacted our firm to advise that upon review of what was submitted, Ms. AP was entitled to benefits since July 2022 and she received a check for all payments made to the ALF to date. She remains on claim and we continue to work with the ALF and Ms. AP’s doctors to make sure Mutual of Omaha has what it needs to timely pay the ALF invoices.
Win: Disability Insurance Law Group Wins Lawsuit Against Hartford Life Insurance Company to Recover Terminated
Disability Benefits for Disabled Client.
Jo El became disabled from her job as a nurse consultant for an insurance company due to severe degenerative disc
disease. Unfortunately, she had difficulty coping with her significant physical limitations and was also diagnosed with
secondary depression.
Unable to work, Jo El filed a claim for disability insurance benefits under a Hartford insurance policy offered by her
employer. The policy provides that Hartford is required to pay Jo El benefits through her 65th birthday if
she remains disabled due to a physical condition. However, benefits are limited to 24 months of payments for
disabilities resulting from a “mental / nervous” condition.
Hartford approved Jo El’s benefits based on her secondary depression and asserted that it was evaluating whether she was
also physically disabled. After an 18 month “investigation,” Hartford informed Jo El that it determined that she was not
physically disabled, and her benefits would terminate in 6 months. Jo El was in her mid-40’s so Hartford’s denial meant
that it was potentially saving itself from paying over 20 years of additional benefits. For Jo El, Hartford’s denial
meant that in 6 months, she would be unable to pay her bills.
This is when Jo El contacted Disability Insurance Law Group. Jo El explained that a lapse in benefits would be
financially devastating. Accordingly, Disability Insurance Law Group had to act fast. Our team sent Jo El to an
independent functional capacity evaluation, obtained an independent vocational analysis, and worked closely with Jo El’s
physicians to obtain compelling evidence of her physical disability. Disability Insurance Law Group prepared a
comprehensive appeal and submitted it to Hartford. Hartford failed to make a timely appeal decision and Disability
Insurance Law Group promptly filed a lawsuit against Hartford in Federal Court seeking to prevent the termination of Jo
El’s benefits.
After the litigation ensued, Hartford admitted that Jo El was physically disabled and overturned its claim decision. Jo
El never experienced a lapse in benefits and continues to receive long-term disability benefits from Hartford.
Win: Disability Insurance Law Group Wins Lawsuit Against Guardian Life Insurance Company of America to Recover
Disability Insurance Benefits for Client.
Gregg was a successful stockbroker. Unfortunately, he was injured in an accident and underwent back surgery. He
attempted to return to work, but his severe pain persisted. He was diagnosed with failed back syndrome, which ended his
career.
Gregg filed a claim for Long-Term disability benefits under an insurance policy issued by Guardian Life Insurance
Company of America, which was offered by his employer. He was approved for benefits under the policy. Gregg was also
determined to be unable to maintain any gainful employment by the Social Security Administration.
As the years went on, Gregg’s condition significantly deteriorated. He underwent multiple surgeries, but nothing helped.
Despite this, after 20 years Guardian sent Gregg a correspondence asserting that he was no longer disabled and
terminated his benefits.
Disability Insurance Law Group filed a lawsuit against Guardian, seeking his disability insurance benefits. In the
lawsuit, Disability Insurance Law Group informed the Court that Guardian missed its claim decision deadline and failed
to provide Gregg with a full and fair review. Ultimately, Guardian admitted that Gregg remained disabled under the
policy, paid all back benefits due, and reinstated Gregg’s monthly disability benefits.
Win: Disability Insurance Law Group Wins Lawsuit Against Hartford Life Insurance Company (Formally Aetna) to Recover
Disability Insurance Benefits for Client.
Paul was an engineer who was recruited by a large corporation. He took great pride in his work and received numerous
awards for his designs. However, Paul began to suffer from significant back pain. At first, he pushed through and tried
to modify how he worked. As time went on, his condition deteriorated, and his pain became excruciating. He was diagnosed
with severe degenerative disc disease. His employer did not want to lose Paul, so it offered him a reduced work
schedule. Paul eagerly accepted, hoping that he would save his career. However, Paul remained in agony and ultimately
had to completely stop working.
Paul filed for Long-Term Disability benefits under an insurance policy issued by Aetna Life Insurance Company, which he
obtained through his employment. Aetna approved his claim. After several months, Hartford Life Insurance Company took
over Aetna and started administering Paul’s claim.
Hartford placed Paul under surveillance multiple times, finding nothing. On one day, Paul was seen carrying a small
object and on months later he was seen driving a very short distance to pick up food for his wife who was caring for her
dying mother. However, this did not deter Hartford. Hartford sent Paul to a medical examination by a doctor it regularly
hires to perform such evaluations. Without any testing, the doctor asserted that Paul was capable of full-time work.
Hartford immediately terminated benefits, citing its’ paid physician’s opinion and the innocuous surveillance video.
This is when Paul contacted Disability Insurance Law Group. We sent Paul to an independent physician, who performed a
full Functional Capacity Evaluation. We also obtained an expert vocational report, sworn statements from Paul’s
physicians, and voluminous medical information. Disability Insurance Law Group sent Hartford a comprehensive appeal,
outlining its unreasonable claim termination. When Hartford failed to timely overturn its claim decision, Disability
Insurance Law Group filed a lawsuit against Hartford.
Shortly thereafter, Hartford admitted that Paul remained disabled, overturned its claim denial, paid all back benefits
due, and reinstated benefits. Hartford continues to pay Paul disability insurance benefits.
Win: DI Law Group Secures benefit for Financial Services Associate with Bipolar and Anxiety Disorder against MetLife
A financial Services Associate with a well-known financial institution reached out to Disability Insurance Law Group after
being denied benefits on the basis that there was insufficient medical proof to confirm that he was unable to work due
to Bipolar Disorder and other Mental Nervous Conditions.
After a successful career, our client was forced to leave his job when his medical condition became overwhelming and
prevented him from being able to effectively and reliably perform his job duties. Despite providing medical records and
physician statements to MetLife that documented and confirmed the severity of his conditions, MetLife denied
benefits and provided our client with 180 days to appeal the denial.
Our Lawyers Successfully Appealed to MetLife
Like many who suffer from psychiatric condition such as Anxiety, Depression, Bipolar Disorder, and Panic Disorder our
client was able to manage his symptoms and work productively for many years. However, a triggering event caused him to
spiral and despite regular treatment and medications he could not regain the level of focus, confidence, ability to
analyze and control of his emotions needed to properly perform his job duties. After some prodding from his treating
therapist, our client faced the fact that he was unable to keep working and made the very difficult decision to apply
for long term disability benefits.
Despite treatment records and a detailed explanation from his psychologist explaining the severity of our client’s
medical condition and why it prevents him from working, MetLife added to his stress by denying his claim.
Our client realized that securing good legal representation would be beneficial and retained DI Law Group. Our
attorney’s filed a detailed and well supported Appeal using expert testimony and physician statements and MetLife
overturned its denial just weeks after receiving the Appeal.
The legal team at Disability Insurance Law Group (DI Law Group) is well versed in the tactics used by MetLife and other
carriers to deny benefits and has the experience and knowledge needed to overturn wrongful denials. If you are faced
with a private or group disability insurance claim and are thinking about applying for benefits, have applied for
benefits but continue to wait for a determination or have been denied benefits, please contact DI Law Group for a free
consultation. We can be reached through our website www.Dilawgroup.com or toll free by calling 855-599-3247.
Win: CNA Long Term Care Insurance pays LTC Benefits
Having researched the difficulties faced by many when applying for Long Term Care benefits, our client’s family reached out to DI Law Group
in an effort to secure LTC benefits as quickly as possible. While their mother had limited financial resources, she had
procured a Long Term Care Policy to cover her needs should she become unable to care for herself.
Once the attorneys at DI Law
Group reviewed and understood the Long Term Care policy terms and what was needed for benefits to be approved, they
worked closely with the Insured’s family, doctors, and long term care facility to timely provide CNA with proof of Chronic Illness and that the insured required Substantial Assistance with at least two
Activities of Daily Living. Additionally, a representative from DI Law Group attended the LTC Nurse Assessment scheduled
by CNA to make sure the Insured’s limitations were properly recorded and the Assessment was fair.
Within a short time, benefits were approved and our client continues to receive LTC benefits which cover her monthly
Long Term Care facility costs.
Whether retained prior to applying for LTC benefits, during the application stage or after benefits were denied, the
attorneys at DI Law Group have successfully handled our clients Long Term Care claims, helping them navigate the process
and pitfalls known to be associated with these claims. If you are faced with a long term care insurance claim and are
thinking about applying for benefits, have applied for benefits but continue to wait for a determination or have been
denied benefits, please contact DI
Law Group for a free consultation. We can be reached through our website www.Dilawgroup.com or toll free by calling (954)-989-9000.
Win: DI Law Group wins Long Term Care Claim against Prudential
Our client and her family reasonably assumed that given our client’s age, medical conditions and obvious physical and
cognitive limitations that her Long Term Care claim would be quickly approved and they could avoid the financial
stress of having to cover most, if not all, of the cost of an Assisted Living Facility. In addition to being very frail
and unsteady, our client had clear cognitive issues which were documented by her doctor and mental health testing. Based
solely upon a biased and improperly documented Nurse Assessment, Prudential denied benefits claiming the Insured could
live independently.
Our Lawyers Successfully Appealed to Prudential
Her family was shocked and upset and contacted our firm to file a Long Term Care Appeal. After reviewing Prudential’s claim file, which included the
Nurse Assessment report, medical records and the comments of the insurance adjusters, our attorneys prepared a
comprehensive appeal. Included were statements by our client’s doctors refuting Prudential’s in house physician’s
opinion, a statement by our client’s daughter who attended the Nurse Assessment with her mother detailing what actually
occurred, a full set of medical records and statements from the ALF’s employees regarding our client’s limitations. It
took less than one month for Prudential to overturn its denial and reimburse our client’s family for the benefits owed
up to that time. We continue to assist our client with her claim and to date she has received her LTC benefits without
issue.
Whether retained prior to applying for LTC benefits, during the application stage or after benefits were denied, the
attorneys at DI Law Group have successfully handled our clieents Long Term Care claims, helping them navigate the
process and pitfalls known to be associated with these claims. If you are faced with a long term care insurance claim
and are thinking about applying for benefits, have applied for benefits but continue to wait for a determination or have
been denied benefits, please contact
DI Law Group for a free consultation. We can be reached through our website www.Dilawgroup.com or toll free by calling 855-599-3247.
Win: 11th Circuit Appeal Against The NFL
Disability Insurance Law Group successfully appealed to the Eleventh Circuit, overturning a district court ruling
denying our client NFL disability benefits. On October 15th, 2020, the U.S. Court of Appeals for the Eleventh Circuit
ruled in favor of our client, Darren Mickell, in the case, Mickell v. Bell/Pete Rozelle NFL Players Retirement Plan. The
Eleventh Circuit held that the NFL abused its discretion when it denied disability benefits to Mr. Mickell under the NFL
Player’s Retirement Plan (The Plan) because it ignored substantial evidence submitted by Mr. Mickell’s attorneys,
cherry-picked evidence, and failed to consider the combined impact of Mr. Mickell’s various conditions and limitations.
Win: Southern District of Florida Court determines that our client is disabled and Aetna unreasonably denied his
claim
In the case of Gharagozloo v. Aetna, Disability Insurance Law Group successfully obtained disability insurance benefits
for our client, overturning Aetna’s denial of benefits. Our client worked for the University of Miami as a data
processor. He had severe carpal tunnel syndrome and had surgery on both hands. He returned to work following the
surgery, but overtime his condition worsened. He attempted to work part-time, but ultimately could not continue to work.
Aetna denied his claim, based on the opinions of two physicians it hired to review our client’s records. Disability
Insurance Law Group filed suit in the Southern District of Florida Federal Court. The Court found that Aetna’s decision
was both wrong and unreasonable. In so doing, the Court rejected all of Aetna’s arguments and attacked the reliability
Aetna’s hired medical reviewers’ opinions.
Win: Client awarded benefits by Guardian Insurance, concluding litigation in the Middle District of Florida
Our client, Dr. Susan L., became disabled from her occupation as a gastroenterologist after suffering injuries to her
leg and hand during two falls. She was approved for disability insurance benefits by Guardian Insurance Company. Several
years later, Guardian denied her claim based on a vocational evaluation by an analyst employed by Guardian. Disability
Insurance Law Group filed suit in the Middle District of Florida Federal Court. The parties engaged in discovery. Prior
to trial, Guardian conceded that its claim decision was wrong, it paid all back benefits owed, and it reinstated Dr. L’
s benefits.
Win: Disability Insurance Law Group successfully overturns denial of disability benefits under the Group AT&T
Disability Insurance Plan
Our client, Mr. C., worked for AT&T for several years. He became disabled and was awarded short-term disability
benefits. However, after a few weeks his claim was terminated by AT&T’s third-party administrator, Sedgwick. Mr. C.
retained Disability Insurance Law Group to appeal the short-term disability claim denial and to seek benefits under his
long-term disability policy. We hired an independent medical expert to conduct a Functional Capacity Evaluation,
gathered all of his medical records, obtained sworn statements from his physicians, and submitted a comprehensive appeal
letter to Sedgwick. We also applied for long-term disability benefits, submitting the information gathered. The claim
denial was overturned, and Mr. C. was also awarded long-terms disability benefits.
Win: Disability Insurance Law Group overturned Unum’s disability benefits denial and obtained benefits for our
client
Our client, Ms. L. worked as a Cardiovascular ECG-Supervisor. After undergoing back surgery, she attempted to go back to
work. However, she was unable to handle the demands of her occupation. She took a less physically demanding position, on
a part-time basis. She filed for disability insurance benefits under the terms of her Unum policy through her
employment. Under the policy, Ms. L. is entitled to benefits if she was unable to perform the duties of her
pre-disability occupation and suffers a loss in income. Unum denied Ms. L.’s claim for benefits, asserting that she
could perform her prior job. Ms. L. hired Disability Insurance Law Group to appeal Unum’s denial. We retained an
independent expert to evaluate Ms. L.’s condition and limitations, obtained written statements from her physicians,
gathered her medical evidence, hired a vocational expert to render an analysis of her earning ability, and prepared a
detailed appeal letter. Based on this information, Unum overturned its claim denial and awarded our client disability
insurance benefits.
Win: Administrative Appeal Against Met Life
We secured all past and ongoing disability benefits for our client who could not work due to chronic, debilitating
cervical and lumbar pain. Mrs. Y filed a claim for disability insurance with MetLife and was initially approved. After a
year of receiving benefits, MetLife terminated Mrs. Y’s benefits based on surveillance video footage which showed Mrs. Y
driving to a doctor’s appointment, eating lunch at a fast-food restaurant, and taking her small dog for a short walk
over a 3-day period. MetLife claimed that this illustrated that Ms. Y was more functional than she indicated. Mrs. Y
hired Disability Insurance Law Group to prepare her administrative appeal. Our Firm broke down the video footage minute
by minute and established that Mrs. Y engaged in very limited activity for less than 7% of the entire three-day period.
We had her physicians evaluate the video and prepare a detailed response explaining why the activity on the video was
not inconsistent with Mrs. Y’s stated functional limitations. Finally, we had Mrs. Y undergo functional capacity testing
with a medical expert, establishing her severe restrictions. The expert also prepared a report refuting MetLife’s claims
regarding the surveillance footage. Based on the detailed and comprehensive appeal prepared by the attorneys
at Disability Insurance Law Group, MetLife reversed its denial of benefits, paid all benefits owed to date, and Mrs. Y
remains on claim.
Win: Benefits Under A Cigna Disability Policy For Claimant Suffering From
Fibromyalgia
Ms. R, the executive of a large corporation, was diagnosed with fibromyalgia. All of her treating physicians opined that she was unable to work.
Despite this, Cigna denied her claim for long-term disability benefits, alleging that she did not submit sufficient
evidence of her disability. Ms. R. retained Disability Insurance Law Group to prepare an appeal of Cigna’s denial of
benefits. In preparing her appeal, Disability Insurance Law Group obtained expert medical and vocational opinions
establishing Ms. R.’s inability to work, interviewed and secured statements from Ms. R.’s physicians, and interviewed
and gathered witness statements from Ms. R. and her family and friends. Disability Insurance Law Group prepared a
detailed appeal letter outlining Cigna’s unreasonable claims handling process and addressing the flaws in Cigna’s hired
medical reviewers’ opinions and submitted the voluminous proof it gathered to Cigna. As a result of the information
contained in the Appeal, Cigna overturned its denial and Ms. R remains on claim.
Win: Appeal Against Cigna For Denial of Long-Term Disability Benefits For Traumatic
Brain Injury, Mental/Nervous Disorder & Physical Conditions
Ms. Doe suffered a serious traumatic brain injury, which impacted all aspects of her life. She filed a claim with her
insurer, Cigna, which ultimately denied her claim. Ms. Doe hired Disability Insurance Law Group to appeal Cigna’s claim
denial. Our Firm retained an independent neuropsychologist to perform testing, which established the severity of Ms.
Doe’s impairments. Additionally, our Firm obtained sworn testimony from Ms. Doe’s physicians outlining her limitations.
Disability Insurance Law Group submitted this information along with a comprehensive appeal letter attacking the
inconsistencies in Cigna’s claim denial letter and its hired physician’s report. We are happy to report that our firm
was able to secure a win on appeal and obtained all benefits owed to Ms. Doe.
Win: Appeal Results In Cigna/LINA Overturning Denial Of Benefits For Lupus And
Fibromyalgia Claim
After suffering from the debilitating effects of lupus and fibromyalgia, Ms. X turned to her insurer, Cigna, for
disability benefits to which she was entitled under her policy. When Cigna initially denied Ms. X’s long-term disability
claim, she enlisted our firm’s help. We submitted a detailed appeal on Ms. X’s behalf, with supporting documentation
explaining why it was so crucial for her to receive benefits. Our firm was successful on appeal, as Cigna/Life Insurance
Company of North America (LINA) ultimately overturned the denial of benefits and approved of Ms. X’s long-term
disability claim.
Win: Disability Approval By MetLife And Guardian Berkshire For Doctor With Neck And
Back Pain
Dr. B. suffered from debilitating neck and back pain. Ultimately, he was no longer able to treat patients. Dr. B. had
two disability insurance policies, a group policy through a medical association and a private policy, which were
supposed to pay benefits if he was unable to perform the duties of his occupation. Dr. B. knew other professionals who
had to apply for disability insurance benefits and their claims were unreasonably delayed or denied by their insurance
carriers. Accordingly, Dr. B. searched for a disability insurance attorney prior to applying for benefits. He was
referred to Disability Insurance Law Group by two colleagues. Our Firm walked Dr. B. through the application process,
worked closely with his physicians to gather the evidence required and point out deceptive insurance company questions
on their claim forms, retained a medical expert to conduct a Functional Capacity Evaluation establishing the severity of
Dr. B.’s condition, and represented Dr. Brown during his insurance company interviews. When Dr. B.’s private insurance
company, MetLife, did not pay benefits immediately following the elimination period, claiming it was “still
investigating” his claim, Disability Insurance Law Group required that MetLife pay him under a “reservation of rights”
to avoid financial strain through the investigation. Both MetLife and Guardian / Berkshire paid Dr. B. all benefits owed
under the policies.
Win: Our Law Firm Successfully Resolves Cardiac Claim Against Disability Insurance
Company
Our client was a litigation attorney for a large law Firm. He developed a severe cardiac condition and could not
continue to litigate cases. He applied for disability insurance benefits under his group disability policy which he
obtained through his employment and under a private policy he purchased years earlier. Both claims were denied. He then
hired Disability Insurance Law Group to seek the denied benefits. Our Firm worked closely with his physicians to gather
his medical evidence and obtain statements attacking the medical conclusions reached by the insurance companies’
physicians. He also retained an expert cardiologist who examined our client, reviewed his records, and rendered an
opinion that he was disabled. We submitted an appeal of the claim denial to the group policy insurance company and a
demand for payment to the private insurance company along with a complaint to the Florida Department of Financial
Services. Both denials were overturned, and our client was awarded the benefits he deserved.
Win: Our Law Firm Successfully Halts Liberty Mutual’s Attempt To Terminate Disability
Benefits With An Independent Medical Examination (IME)
Our client, Ms. J., was receiving disability benefits through her disability insurer, Liberty Mutual. Ms. J. was also
determined to be disabled from any gainful employment by the Social Security Administration. Ms. J.’s Liberty Mutual
policy defined disability for the first 24 months as the inability to perform the duties of her prior occupation (“Own
Occupation stage”). After 24 months, it defined disability as the inability to perform the duties of any occupation
(“Any Occupation” stage). Three months prior to the change in definition, Liberty Mutual required Ms. J. to attend a
Compulsory Medical Examination (“CME”) by a physician it hired. She complied. Based on the results of the CME report,
Liberty Mutual terminated her benefits, alleging that she could perform sedentary work within the healthcare industry.
Our firm was retained by Ms. J. to appeal the claim denial. We hired a medical expert to conduct a thorough examination
of Ms. J. and review of her medical evidence. The expert also reviewed Liberty Mutual’s CME report and attacked the
conclusions. We also obtained statements from Ms. J.’s physicians outlining Ms. J.’s limitations and secured her social
security file. This information was submitted to Liberty Mutual with a comprehensive appeal letter. Liberty Mutual
overturned its termination of benefits, Ms. J. was awarded all back benefits owed to her, and she continues to receive
disability benefits.
Win: Our Law Firm Successfully Resolves Long-Term Care Claim Against Genworth
A 91-year-old woman was entitled to home health care benefits under her long-term care policy with Genworth Insurance
Company. Unfortunately, many long-term care insurance companies take advantage of insureds that are ill or elderly and
do not have the physical and/or mental stamina to deal with their unfair, and often unconscionable, delay tactics. This
was the case with Ms. W. Genworth delayed making a determination for several months and then ultimately denied her
claim. Ms. W.’s children hired our Firm to help obtain the benefits Ms. W. deserved and the medical care she desperately
needed. We worked with the facility to establish the medical necessity of the care and submitted a demand letter to
Genworth and a complaint to the Florida Department of Financial Services. Genworth overturned the denial and covered all
expenses.
Win: Appeal Results In MetLife Overturning Denial Of Benefits For Depression And
Anxiety Claim
Mr. X was a successful stockbroker in New York. Sadly, as the result of family-related issues, including the death of
his mother after a prolonged battle with cancer, he experienced severe anxiety and major depression. Ultimately, he was
unable to continue to work as a stockbroker. Mr. X applied for benefits under the terms of his MetLife disability
insurance policy. After a prolonged “investigation,” MetLife denied Mr. X.’s claim, asserting that his medical records
did not clearly establish limitations or an inability to work in his occupation. Mr. X hired Disability Insurance Law
Group to fight the claim denial. We obtained expert medical and vocational e Biden e establishing Mr. X’s disability.
MetLife overturned its denial of benefits.
Win: We Successfully Overturned MetLife’s Disability Insurance Denial Of Kindergarten
Teacher
Ms. A was a school teacher who became unable to handle the demands of her job due to a herniated disc, fibromyalgia, and
chronic fatigue. She applied for benefits under the MetLife disability insurance policy that she obtained through her
employment. For the first 24 months, her MetLife policy defined disability as the inability to perform the duties of her
prior occupation (“Own Occupation stage”). After 24 months, the definition of disability changed to the inability to
perform the duties of any occupation (“Any Occupation” stage). After receiving benefits for 23 months, MetLife sent Ms.
A. a letter stating that it was terminating benefits. MetLife alleged that she could work in a sedentary occupation and
claimed that its vocational analyst identified three occupations that she could perform. Ms. A. hired Disability
Insurance Law Group to appeal the claim denial. We interviewed her physicians and obtained detailed statements regarding
Ms. A.’s limitations. Disability Insurance Law Group hired an independent medical expert to examine Ms. A and review her
records. She rendered a report outlining Ms. A.’s functional limitations. Our Firm also retained an independent
vocational analyst to assess Ms. A.’s employability. He performed a transferable skills analysis, determining that Ms.
A. was not capable of maintaining gainful employment, including the jobs listed by MetLife. This information was
submitted with a thorough appeal letter. MetLife overturned its claim termination.
Win: We Successfully Overturned Standard Insurance’s Denial Of Disability Benefits For
Accountant With Multiple Sclerosis
As a partner at a large accounting firm for nine years, Mr. D started to experience severe and debilitating symptoms. He
was ultimately diagnosed with Multiple Sclerosis (MS). Unfortunately, Mr. D’s condition continued to deteriorate and
eventually he was unable to continue to work. He filed a claim for long-term disability benefits under the terms of his
group policy issued by Standard Insurance Company. Standard denied his claim, alleging he was actually suffering from
MS, but rather from Carpal Tunnel Syndrome (CTS), which Standard claimed was only mildly limiting his functionality. His
MS experts encouraged him to contact Disability Insurance Law Group, Mr. D. retained our Firm, and we submitted an
appeal on his behalf outlining the unreasonableness of the denial and highlighting the extensive evidence of his
condition and limitations. The denial was overturned, Mr. D. was awarded all back benefits owed, and he remains on
claim.
Win: We Successfully Reversed Prudential’s Denial Of Short-Term Disability Benefits
And Obtains Long-Term Disability Benefits For Attorney Disabled By Multiple Sclerosis
Ms. V. was an accomplished attorney at a medium-sized law firm when she began experiencing severe fatigue and vertigo.
Overtime, her symptoms progressed and became more concerning. She was unfortunately diagnosed with Multiple Sclerosis
(MS). Ultimately, her condition became so severe that she was unable to continuing working. Ms. V. filed a claim for
disability insurance benefits with her insurer, Prudential. Despite the support of her treating experts, Prudential
denied her claim alleging that there was insufficient objective evidence of her disability. One of the other partners in
her law firm encouraged her to contact Disability Insurance Law Group. She retained our Firm to fight Prudential’s claim
denial. We obtained Ms. V.’s medical records which noted that Ms. V. Was complaining of severe physical and cognitive
impairments. We retained an independent medical expert to conduct functional testing, which established that she was
suffering from significant physical limitations and restrictions. We also hired an independent neuropsychologist to
conduct testing, which revealed that Ms. V. Was suffering from MS related cognitive impairments. This information was
submitted with a detailed appeal letter addressing that her symptoms were consistent with her condition and prevented
her from working as an attorney. Prudential had the information evaluated by their in-house physician who ultimately
agreed with are assessment. Prudential overturned its denial and Ms. V was awarded benefits under her short-term and
long-term disability policies.
Win: We Successfully Overturned Prudential’s Termination Of Lupus Claimants Disability
Insurance Claim
Ms. X suffered from severe and systemic lupus for many years. Overtime, her condition worsened, and symptoms became
debilitating. Ms. X filed a disability insurance claim with her insurer, Prudential Insurance Company and her benefits
were approved. She received benefits without issue for almost two years before Prudential abruptly and without notice
terminated her benefits. Unable to work and reliant on those benefits, Ms. X retained Disability Insurance Law Group to
fight her claim denial. We worked closely with Ms. X’s physicians and obtained sworn statements establishing her
continued disability. We also obtained video testimony from Ms. X illustrating her symptoms and limitations. Further, we
retained vocational and medical experts, who opined that she remained disabled. This information was submitted with a
detailed administrative appeal letter. We were able to successfully overturn Prudential’s termination of benefits and
reinstate the benefits Ms. X deserved.
Win: Delayed Claim Approved After Our Law Firm Attends Field Interview
Ms. R enjoyed a fulfilling career as a pharmacist for many years when she started to notice vision impairment. Within a
short period of time, her vision rapidly declined. Ultimately, she was diagnosed as being legally blind by her
physician. Unable to safely perform her duties as a pharmacist, Ms. R filed a claim for disability insurance benefits
under the terms of her Hartford Insurance policy. Hartford engaged in a prolonged “investigation” of her claim, delaying
the payment of benefits. After several months, Hartford informed Ms. R that it required an in-person field interview and
would be sending an investigator to her home. Hartford stated that following the interview, Hartford would be scheduling
a Compulsory Medical Examination of Ms. R and a Hartford physician would need to speak with her physicians before a
decision could be made. Frustrated by them delay and concerned about falling victim to the insurance company’s deceptive
denial tactics, Ms. R retained Disability Insurance Law Group. We informed Hartford that the interview would be
conducted at our office and in our presence. We obtained sworn statements from her physicians and brought them to the
interview. We also demanded that Hartford pay benefits within a set period of time, or we would have to file a lawsuit.
The interview was conducted a few days after we were retained and within a week Hartford paid Ms. R all benefits, she
was owed.
How Can Our Legal Team Help You With Your Claim?
As you can see, insurance companies use many tactics to deny claimants the benefits they deserve. You don’t have to
fight the insurance company on your own. If you are considering filing a disability claim, have issues with insurance
companies’ requests for an IME or other documents, have received a denial letter, or just have questions about the
insurance claim process, please feel free to contact us for a free consultation. We handle cases nationwide. Call 954-989-9000 today.