Insured Does Not Need a Proper Diagnosis Or Supporting Objective Tests To Prove Disability

The recent case of Abrams v. Unum life Ins. Co. of America, 2022 US Dist. LEXIS 23195T0 highlights that a claimant may prevail on his/her disability claim without supporting objective medical evidence or even a proper diagnosis.   In April 2020 Mr. Abrams, who was a trial and appellate lawyer, began to experience frequent, almost daily, fevers. He also experienced severe fatigue and mental fogginess. He saw seven medical doctors with different specialties. He complained of the same symptoms of brain fog, fatigue, decreased attention and concentration and fevers. Three of his doctors diagnosed him with Long-Covid and four with [...]

By |February 27th, 2023|Categories: Legal Updates|0 Comments

Life Insurance Company Collects Premiums From Ineligible Employee

Stennett & Casino filed suit against our client’s life insurance company for not paying benefits following his wife’s death. Sally taught the hearing-impaired at the public school. She herself was deaf and communicated mostly by sign language. Her speech is called deaf speech which is difficult to understand until one becomes accustomed to it. Sally’s benefit package as a teacher included life insurance and disability insurance. The premiums for those insurances were deducted from her paycheck.  Both policies were written by the same Insurance Company. Sally received a cancer diagnosis in early 2020. She stopped working as a teacher in [...]

By |December 20th, 2022|Categories: Uncategorized|0 Comments

Death from Drug Overdose Was an Accident – Not Suicide

Client’s husband died from an overdose of a combination of prescribed drugs, including [drug* and drug*] Decedent had suffered from a very painful condition that required long-term use of the prescribed narcotics. Over the last year before his death, he had been unable to work but had hidden that from his wife by pretending to go to work each day.  He had been depressed and was in severe financial debt at the time of his death. In order to avoid liability under an accidental death policy, MetLife claimed that the death was not “accidental”, but rather the result of suicide.  [...]

By |October 11th, 2022|Categories: Legal Updates, Success Stories|Tags: |0 Comments

Side Effect of Medication Causes Disability

The Federal District Court in San Diego issued an opinion granting disability benefits to a client of Stennett & Casino that contains several quotable statements relevant to ERISA disability claims. Stennett & Casino’s client’s claim was that side effects from medication taken to control seizures (fatigue and cognitive slowing) prevented him from returning to work. The disability insurer, Lincoln National, initially paid disability benefits while our client was actively having seizures. But once the medication successfully controlled his seizures Lincoln National, terminated his benefits based on the opinions of two physicians retained by Lincoln National who neither examined nor talked [...]

By |September 8th, 2022|Categories: Legal Updates, Uncategorized|0 Comments

Post-Chemo Disability

When a diagnosis of cancer is followed with treatments that include chemotherapy, patients often experience lingering symptoms of fatigue, muscle weakness, brain fog (often called chemo brain), decreased ability to concentrate, and peripheral neuropathy. In some people, these symptoms can last well past the remission of cancer.   This is precisely what happened to a client of Stennett & Casino who had a disability policy through her employer with United of Omaha. Omaha provided disability benefits while she was going through treatment. But those benefits were terminated by Omaha after she went into remission.   Though her cancer was in [...]

By |August 1st, 2022|Categories: Disability Insurance Claims|0 Comments

Insurer Rescinds Policy for Failure to Disclose High Blood Pressure

Our client’s husband died unexpectedly at age 48 following a massive heart attack.  Fortunately, he had a life insurance policy. Unfortunately, the insurance company denied her claim for benefits. The denial was based on the fact that her husband had not disclosed his history of high blood pressure to the insurance company when he first applied for the coverage. Insurers may rescind a life insurance policy within 2 years of its issuance if it discovers the applicant made a misrepresentation that the insurer reasonably relied upon in issuing the life policy. The key is whether the misrepresentation (whether innocent or [...]

By |June 13th, 2022|Categories: Success Stories|0 Comments

Post-Covid Syndrome Can Support a Claim for Disability Benefits.

Most people with Covid-19 recover completely within a few weeks. However, some people, even those with mild versions of the disease, continue to experience symptoms after their initial recovery. Even people without Covid-19 symptoms in the days or weeks after they were infected can have post-Covid conditions. These conditions can present as different types and combinations of health problems for different lengths of time.   These post-Covid conditions may also be known as long-Covid, long-haul Covid, post or chronic Covid. The Center for Disease Control (CDC) and experts around the world are working to learn more about short and long-term [...]

By |June 2nd, 2022|Categories: Legal Updates|0 Comments

Who Has The Burden of Proof In An Insurance Claim

Whether you make a claim for benefits under an Accidental Death Policy or a Disability Policy the same burden of proof rules apply. The claimant has the burden of proving that they qualify for policy benefits (that they are disabled in a disability policy claim or that the death was accidental in an accidental death policy claim). However, the insurer has the burden of proving that any claimed exclusion in the policy applies to defeat coverage. As an example, in an accidental death claim the claimant must prove that the death resulted from an “accident” but the insurer who denies [...]

By |May 3rd, 2022|Categories: Legal Updates|0 Comments

Coverage Under Accidental Death Insurance Policies for Drug and Alcohol Overdoses

Accidental Death and Disability policies (AD&D) require that one’s death be caused by an “accident” to trigger coverage. The term “accident” is usually defined as an “unforeseeable, unintended, and sudden event.” These policies will also contain several exclusions including one for death due to an illness or the treatment thereof. Insurers continually deny benefits under an accidental death policy when death results from an accidental overdose of prescription drugs. When death is caused by medication that is prescribed to treat an illness insurers cite the “illness and treatment thereof” clause to deny the claim. Despite this exclusion Stennett & Casino [...]

By |August 17th, 2021|Categories: Uncategorized|0 Comments

Zurich Claims Subdural Hematoma Not Caused by Fall.

Our client’s husband died as a result of a subdural hematoma (bleeding on the brain).  Subdural hematomas are typically caused by trauma to the head.  Our client found her husband unconscious on the bedroom floor upon returning from church.  He died several days later in the hospital. Zurich, who provided Accidental Death Coverage, claimed that the subdural hematoma was caused by a spontaneous bleed due to the use of Coumadin (a blood thinner), and not by the fall. Zurich pointed to the lack of evidence of external trauma to the head and medical literature supporting the potential for spontaneous bleeds [...]

By |May 11th, 2021|Categories: Uncategorized|0 Comments
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