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Lupus Sufferer Denied Benefits by Insurer

Lupus Sufferer Denied Benefits by Insurer

The Nature of the Case

O.A., a successful Audit Manager at Ernst & Yong was diagnosed with Lupus, a severe autoimmune disease. The illness made it impossible to continue with the very demanding, and stressful role as an accounting professional.

Days that were spent working became days spent undergoing treatment and rehabilitation in an effort to control the illness. O.A. was unable to continue working.

O.A.’s insurer paid her disability benefits for a period of twelve years, however, they suddenly and unexpectedly cut off her benefits leaving her without any income or means to survive. Despite producing extensive medical documentation and submitting it to the insurer, she was ignored.

The Resolution

Bogoroch & Associates issued a statement of claim to the insurers to commence the legal process. Medical evidence was gathered proving the severity and long-term consequences of the disease. Also documentation was gathered to prove that the insurer had acted in bad faith, and by discontinuing all communication had behaved in an unethical manner.

The case moved to a day-long mediation where both parties determined to settle the matter. A fair and reasonable settlement was agreed upon. It was also agreed that the payout would be provided to O.A. tax free.

After nearly two years, Richard Bogoroch was able to provide O.A. with the peace of mind to move forward with her life without financial worry and strain. Though O.A. had tried to communicate with the insurance company, it was only through the representation of the Bogoroch team that a fair and reasonable settlement was achieved.

*Please note that the settlement amounts will vary from case to case and are not reflective of what your case may be worth.