When Guardian Life abruptly terminated considered one of our shopper’s long-term incapacity (LTD) advantages, we knew we had a combat on our fingers. Her case illustrates the significance of difficult insurers who unfairly deny claims primarily based on profit limitations for psychological and nervous situations—and why having skilled authorized illustration could make all of the distinction.
Our Consumer’s Story
For two years, our shopper obtained LTD advantages from Guardian because of her lack of ability to work. Nonetheless, Guardian determined to terminate her advantages, citing a 24-month restrict (or most advantages payable underneath the coverage) for psychological well being situations. They claimed that her PTSD and ADHD have been the only foundation for her incapacity, regardless of her in depth historical past of great bodily situations, together with:
Having conveniently ignored her important bodily impairments, it was clear to us that Guardian’s resolution was unjustified.
Our Attraction Technique
We used our years of expertise to put together an enchantment robust sufficient to problem Guardian’s denial. Right here’s how we approached the method:
- Specializing in Bodily Impairments: We demonstrated that our shopper’s bodily situations—not simply her psychological well being diagnoses—have been independently disabling. By submitting in depth medical data, we left little question that her bodily limitations prevented her from performing even sedentary work.
- Uncovered Flaws in Guardian’s Analysis: We rigorously analyzed Guardian’s resolution and identified its errors, together with its failure to think about the complete extent of our shopper’s impairments and its reliance on outdated or incomplete medical opinions.
- Using Knowledgeable Testimony: We labored along with her treating physicians and different specialists to acquire compelling medical opinions and vocational proof demonstrating her lack of ability to return to work in any capability.
Our Outcomes
In gentle of the overwhelming proof we introduced, Guardian reversed its resolution and reinstated our shopper’s long-term incapacity advantages. This victory ensured that she would proceed to obtain the monetary help she wanted to give attention to her well being and well-being. We recovered practically 5 figures in overdue advantages and the potential for over $100,000 in future advantages.
Don’t Let a Lengthy-Time period Incapacity Denial Take Away Your Monetary Safety
In case your long-term incapacity advantages have been denied or terminated, you don’t have to just accept the insurance coverage firm’s resolution. On the Ortiz Regulation Agency, we now have the expertise and data to tackle even the biggest insurers and can combat for the advantages you deserve.
Contact us on-line or name us right this moment at (888) 321-8131 for a free case analysis. Don’t wait—your monetary stability and peace of thoughts are too necessary to go away within the fingers of an insurance coverage firm. Allow us to provide help to combat again.
