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Success Stories 2018-03-23T02:50:33+00:00

AD&D Policy Covers Death Caused By Medical Malpractice

Accidental Death and Disability (AD&D) policies cover loss caused by “accident.” Accident is generally defined by the courts as an “unexpected and unintended” occurrence. Thus though injury from a medical procedure may be part of the normal risk of the procedure (and thus not unexpected) injury due to the negligence of the doctor is never expected or intended and thus is classified as an accident. Nevertheless insurance companies typically deny claims for AD&D benefits arising out of medical malpractice. This is often due to an exclusion in most policies for loss caused by sickness or the treatment thereof. However, depending [...]

By | May 5th, 2015|Categories: Accidental Death Insurance Claims|0 Comments

A Tale of Two Life Insurance Companies – One (LINCOLN NATIONAL) Pays Accidental Death Benefits And One (CIGNA) Denies Benefits

Our Client’s Husband, who had a history of alcohol issues, died following an evening of binge drinking.  The coroner’s office classified the manner of death as “accidental” and the cause of death as “acute alcohol intoxication.”  The Husband had two insurance policies that promised benefits to his wife if he died as a result of an accident. Our client submitted a claim to each of the insurance companies and both denied coverage under an exclusion for loss caused by “sickness or disease.”  Both insurance companies claimed that a contributing factor to decedent’s death was his alcoholism which they asserted excluded [...]

By | February 11th, 2015|Categories: Accidental Death Insurance Claims, Success Stories|0 Comments

CIGNA Reprimanded For Denying Benefits to Claimant With Chronic Fatigue Syndrome

The Ninth Circuit Court of Appeals in Salomaa v. Honda LTD Plan 637 F.3d 958 found that CIGNA’s Insurance Company’s decision to deny disability benefits to a claimant with chronic fatigue syndrome was illogical, implausible and without support because: Every doctor who personally examined the insured concluded that he was disabled; The Plan Administrator demanded objective tests to establish the existence of a condition for which there are no objective tests; The Administrator failed to consider the Social Security Disability Award; The reasons for denial shifted as they were refuted, were largely unsupported by the medical file, and only the [...]

By | November 20th, 2014|Categories: Disability Insurance Claims, Success Stories|0 Comments

UNUM Denies Accidental Death Benefits Due to Poor Health of Insured

Our client's husband died after falling and hitting his head on their back patio.  The trauma caused a subdural hematoma which became mortal in less than four hours.  The death certificate classified the death as "accidental."  The "immediate cause" of death was listed as "subdural hemorrhaging from blunt force injury to head" and a "contributing condition" was listed as "thrombocytopenia." Client submitted a claim to UNUM Insurance Company for benefits under an accidental death policy.  UNUM denied the claim based on a limitation in the policy that excludes coverage for accidental losses "caused by, contributed to by,  or resulting from diseases [...]

Disability Claim – Surveillance Video – Back Injury

Our client was in a serious auto accident at the age of 22, which confined him to a wheelchair due to serious back injuries.  Despite his serious disability, he returned to school to learn computer programming.  He successfully returned to the workforce and became a program manager for Oracle Corp.  Due to a combination of his serious back injuries and the wear and tear after 17 years of working as a computer programmer and manager, his back finally gave out, precluding him from working full time.  He applied for and received long term disability benefits. Four years later, on December [...]

By | July 25th, 2012|Categories: Disability Insurance Claims, Success Stories|0 Comments

Disability Claim – Degenerative Back

Our client was a pharmacist for 32 years.  His back began to bother him the last 6-7 years before he was unable to continue work.  Pharmacists must be on their feet almost all day and his back condition precluded him from standing more than 20 minutes at a time.  The disability insurer denied benefits after doing a job survey to determine that other employers (not our client's) would allow him to use a stool to accommodate his back problem. Stennett & Casino retained a vocational expert who performed a more thorough job market survey and found that although employers by [...]

By | July 25th, 2012|Categories: Disability Insurance Claims, Success Stories|0 Comments
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