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Severely Disabled Woman’s Insurance Benefits Cut-Off

Severely Disabled Woman’s Insurance Benefits Cut-Off

Nature of the Case

L.P., a long-time Administrative Assistant, suffered from a variety of debilitating illnesses. She suffered from schizo-affective symptoms including severe anxiety, paranoia and social phobia. She also suffered acute groin pain and underwent surgery for a hernia. She could no longer work and was granted disability benefits for a period of under six years. Claiming she had recovered and was able to work, the insurer cut off all subsequent benefits.

In the interim, L.P. made many attempts to rehabilitate physically and mentally. When her insurer confirmed that she in fact had completed her set and recommended rehabilitation program, it discontinued benefits. Assuming L.P. could then resume employment, an argument had to be made on her behalf to prove otherwise.

L.P. was still suffering acute physical pain as well as displaying severe psychological symptoms including social paranoia.

The Resolution

Bogoroch & Associates issued a statement of claim against the insurer. Medical reports for the various illnesses were gathered after L.P. visited a number of experts seeking factual opinions.

Interestingly, one medical report obtained – drafted by the insurer’s reviewing physician – noted that L.P. was fit to work, but unable to sit for more than 30 minutes at a time. Given that L.P. was an Admin. Assistant, sitting, it was argued, it critical to performing the job.

The insurer had not adequately measured the degree to which L.P.’s psychological impairments were affecting her work and her life. Bogoroch & Associates outlined and detailed the severity of those impairments and ensured that all aspects of L.P.’s disability were understood by the insurer.

The case was settled at a mandatory mediation whereby the insurance company was forced to accept the severity of L.P.’s ongoing pain and suffering. A tax free settlement was agreed upon, and L.P. was able to move forward with her life without the incredible strain of financial worry. Though L.P. was faced with her complex illnesses, she could continue to rehabilitate and work toward improved health.

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