Patient denied disability claim after brain surgery
A man is suing Life Insurance Co. of North America, claiming that the insurance carrier wrongfully denied his long-term disability claims. The man was diagnosed with a brain tumor in 2012 and was declared disabled.
He underwent two brain surgeries and radiation therapy. Those treatments left him with permanent damage. The plaintiff alleges that he was receiving disability benefits from the insurance company.
When a skills analysis was completed by the insurance company, the results indicated that the man could work as a boat dispatcher, the job he had before his diagnosis. The insurance company then stopped the plaintiff’s disability benefits.
The man is now seeking a jury trial and the unpaid benefits of the long-term disability plan. The plaintiff also seeks the costs of the lawsuit, including his attorney’s fees and any other relief that the court believes is appropriate.
The man believes that the insurance company violated his rights under the Employee Retirement Income Security Act. According to the Department of Labor, ERISA is a federal law that sets the minimum standards for health plans in the private industry. It is there to provide protections for those individuals who are in these plans.
When an insurance company denies benefits to an injured or ill individual who is rightfully covered, there are steps that may be taken. An attorney can help those individuals seek the benefits through the appeals process or through civil court. In some cases, the insurance company may offer a settlement instead of going through a civil court lawsuit. Your lawyer can explain your legal options in such cases so that you can make an informed decision as to your next step.
Source: Northern California Record, “Life Insurance Co. of North America allegedly denied patient disability payments after undergoing brain surgery,” Jenie Mallari-Torres, Sep. 02, 2016