Assurant overturned its previous denial of long term disability benefits for Maine Sales Consultant

Our client, Ms. C, formerly worked as a Sales Consultant for an international manufacturer of dental materials. In July 2013 a number of medical issues, including the debilitating effects of chemotherapy treatment as well as recurrent breast cancer forced Ms. C to stop working and submit her claim for disability benefits first under her employer’s short-term disability (STD) policy and then continuing under its long-term disability (LTD) policy. Both benefits were funded and administered by Assurant. Under her employer’s disability policy Ms. C would be considered totally disabled if she was unable to perform the material duties of “any gainful occupation” for which she was qualified by education, training and experience and with additional consideration of her functional limitations and transferable skills. Material duties included, among other things, the sets of tasks or skills required generally by employers from those engaged in an occupation, which cannot be reasonably accommodated.

After paying Ms. C for 24 months under the Policy’s “own occupation” definition of disability, Assurant denied continued LTD benefits on the basis that she allegedly no longer met the policy definition of disability. Specifically, Assurant stated that Ms. C’s condition had “improved to allow [her] to perform full-time sedentary and light work.” After receiving the denial, Ms. C contacted Dell & Schaefer and discussed her case with Attorney Jay Symonds. Attorney Symonds identified several significant issues in Assurant’s denial letter and in the evidence it relied on and agreed to prepare and submit Ms. C’s ERISA appeal with the assistance of his appeal team.

The LTD appeal addressed all of Assurant’s short-comings and reasons for denial, with a special focus on the medical records on and around the date of Assurant’s denial and significant inconsistencies with its medical reviewer’s findings. The appeal next addressed Assurant’s mischaracterizations and overstatements regarding the nature and relevance of Ms. C’s purported activities. Finally, the appeal addressed Assurant’s incorrect and incomplete vocational assessment by retaining a vocational expert to discredit Assurant’s report and establish that Ms. C was, in fact, incapable of performing any sedentary occupation in light of her documented physical and cognitive restrictions and limitations.

Just over five weeks later, and after reviewing the appeal and hundreds of pages of exhibits and medical records, Assurant overturned its decision to terminate benefits and reinstated Ms. C’s long-term disability benefits.

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FAQ

Do you help Assurant claimants nationwide?

We represent Assurant clients nationwide and we encourage you to contact us for a FREE immediate phone consultation with one of our experienced disability insurance attorneys.

Can you help with a Assurant disability insurance policy?

Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Assurant. We have helped thousands of disability insurance claimants nationwide with monthly disability benefits. With more than 40 years of disability insurance experience we have helped individuals in almost every occupation and we are familiar with the disability income policies offered by Assurant.

How do you help Assurant claimants?

Our lawyers help individuals that have either purchased a Assurant long term disability insurance policy from an insurance company or obtained short or long term disability insurance coverage as a benefit from their employer.

Our experienced lawyers can assist with Assurant:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
  • ERISA and Non-ERISA Disability Benefit Lawsuits
  • Applying For Short or Long Term Disability Benefits
  • Daily Handling & Management of Your Disability Claim
  • Disability Insurance Lump-Sum Buyout or Settlement Negotiations

Do you work in my state?

Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.

What are your fees?

Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

The three available fee options are a contingency fee agreement (no attorney fee or cost unless we make a recovery), hourly fee or fixed flat rate.

In every case we provide each client with a written fee agreement detailing the terms and conditions. We always offer a free initial phone consultation and we appreciate the opportunity to work with you in obtaining payment of your disability insurance benefits.

Do I have to come to your office to work with your law firm?

No. For purposes of efficiency and to reduce expenses for our clients we have found that 99% of our clients prefer to communicate via telephone, e-mail, fax, GoToMeeting.com sessions, or Skype. If you prefer an initial in-person meeting please let us know. A disability company will never require you to come to their office and similarly we are set up so that we handle your entire claim without the need for you to come to our office.

How can I contact you?

When you call us during normal business hours you will immediately speak with a disability attorney. We can be reached at 800-682-8331 or by email. Lawyer and staff must return all client calls same day. Client emails are usually replied to within the same business day and seem to be the preferred and most efficient method of communication for most clients.

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