Bartolic Law helped a client suffering from lumbar radiculopathy who performed physically demanding work. Reliance terminated long-term disability benefits contending the client could perform sedentary work in other occupations. Using a two-pronged approach, we both demonstrated the client could not perform his prior work or seated work physically, and we used vocational evidence to show the only occupations Reliance Standard identified as meeting the earnings qualifier were ones that had not existed in the American economy for decades. As a result, Reliance Standard agreed to maintain our client’s long-term disability payments. When a client’s parent got diagnosed with stage 4 Pancreatic Cancer, she had to stop working. Our client, the beneficiary of the life insurance policy, with the mother, called Reliance Standard, the life insurer, to ask how the insured could maintain coverage given the diagnosis and prognosis. The agent advised them to apply for waiver of premiums, though the deadline to do so had lapsed, but the right to unconditionally convert to individual coverage had not yet expired. After the insured received notice Reliance Standard denied the application for waiver, she tried to convert but Reliance then contended it was too late to do so. But had they been told in the first phone call about the right to convert, coverage would have been maintained. Notwithstanding Reliance Standard’s dispute regarding coverage, we were able to recover for the client. Reliance Standard claims management can be challenging, and Bartolic Law has helped many navigate through its hurdles. Call us to see how we can help you.
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)