Bartolic Law has successfully obtained long-term disability benefits and judgments against Mutual of Omaha. In one case, our client suffered from chronic back pain and received a disability award from the Social Security Administration. After Mutual of Omaha disregarded an existing functional capacity evaluation, and focused on features it should have contained, we had the client obtain another addressing all the criticism. After relying on its own medical director’s opinion, Mutual of Omaha refused to pay the claim, ignoring the extensive history of the client trying every available treatment and medication. In a decision highly critical of Mutual of Omaha, the court granted our client judgment. In another case on behalf of an accountant suffering from Chronic Migraines, we obtained a detailed headache log documenting daily symptoms and effects on productivity for over a year. We combined this with a long history of trying every available treatment, including Botox injections. In one client’s case, the dispute focused on whether the client could transition to an alternate occupation that paid the required wage. We obtained a detailed vocational opinion attacking the insurer’s common practice of assuming individuals can earn the median wage in any occupation for which they have little to no transferable skills. Thanks to the judgment we secured, the client continues receiving monthly disability payments.
Mutual of Omaha (also known as United of Omaha) primarily issues group long-term disability insurance policies, enforced under ERISA § 502(a), and life insurance and accidental death insurance policies. Its policy maximum monthly benefits can be lower than with some larger insurers, meaning there is a lower threshold for what constitutes a significant claim to Mutual of Omaha. Like many insurers, Mutual of Omaha has a practice of deeming claimants qualified for jobs to which they have minimal, if any, transferable skills, and concluding the claimants can earn a median wage in a new line of work. Despite rejection by a court, it continues, but you can challenge it.
Some of its claims are also reinsured, meaning another insurance company you do not know is involved in decisions on your claim. This results in needing to ask a second insurance company if it will agree to pay the claim, leaving you again in a position of needing two approvals to get paid, but only one to get denied.
Ferrin v. Aetna Life Ins. Co., 336 F. Supp. 3d 910 (N.D. Ill. Sept. 28, 2018) (holding insurance policy’s grant of discretionary authority is void under Texas law due to certificate being issued after effective date of regulation, and policy renewing after effective date, and holding Plaintiff was disabled from Any Reasonable Occupation where treating doctors certify she can sit at the occasional level, and insurer’s consultants opine Plaintiff can sit frequently, as weighing all evidence together would make capacity likely at low end of frequent range at best).
Sadowski v. Tuckpointers Local 52 Health & Welfare Trust, 281 F. Supp. 3d 710 (N.D. Ill. Dec. 20, 2017) (holding plan was arbitrary and capricious in denying medical benefits for removal of spinal cord stimulator following a fall down the stairs and infection where plan argued the expenses were caused by the same injury as the car accident necessitating implantation of the stimulator years earlier)
Tassone v. United of Omaha Life Ins. Co., 264 F. Supp. 3d 867 (N.D. Ill. Aug. 30, 2017) (awarding client long term disability benefits denied by United of Omaha despite insurer’s doctor opining there was no objective evidence of functional impairment)
Suson v. PNC Fin. Servs. Grp., Inc., No. 15-CV-10817, 2017 WL 3234809 (N.D. Ill. July 31, 2017) (holding Liberty Mutual’s denial of client’s long term disability benefits was arbitrary and capricious where Liberty Mutual disregarded client’s carpal tunnel syndrome and relied on a vocational opinion to which client never had an opportunity to address before litigation)