Court Orders Life Insurance Company Of North America To Pay Claimant Long-Term Disability Benefits

After failing to pay a LINA disability policyholder his entitled disability benefits the insurance company was forced by a New York court to follow through with its contractual obligations. Curt, a former employee of BorgWarner Morse TEC Inc. received long-term disability benefits under the group insurance policy issued by LINA. LINA later concluded the BorgWarner employee no longer met the definition of disabled under the policy and terminated his benefits.

Curt and his New York disability attorney sued LINA asking the district court to order LINA to pay Curt his disability benefits as well as prejudgment interest and attorney’s fees.

Curt worked as a Senior Designer/Automotive Design Drafter for BorgWarner at the time he went out on medical leave. After working for BorgWarner for more than 20 years Curt was diagnosed as suffering from diabetes mellitus, lower back pain, neck pain, hypertension, sleep apnea, congestive heart failure and coronary artery disease. Curt made a claim to LINA for short-term disability benefits, which was approved and paid by LINA from June 2004 through December 2004. Curt’s claim was then transitioned to a claim for LTD benefits which was approved on January 2005, effective December 2004. About a year later, LINA notified Curt that it was beginning an investigation to determine if Curt was disabled under the Policy’s “any occupation” definition of disability, which would be effective June 2007. LINA then requested updated medical information from Curt’s treating physicians.

The collective opinions submitted by Curt of his treating physicians confirmed that Curt was totally disabled from any occupation with one physician stating: “[Curt’s] ‘prognosis is poor’ and he is frequently unable to perform many daily living tasks, let alone be able to work in any capacity. I do not feel that [Curt] will ever be able to return to work.” Nevertheless, LINA hired a vocational rehabilitation counselor who reviewed Curt’s medical records and concluded that Curt was capable of functioning in a full sedentary capacity and in some light capacity. Based on its hired doctor’s opinions, LINA requested a transferable skills analysis (“TSA”) to identify occupations that Curt would be capable of performing.

In June 2007, LINA terminated Curt’s benefits claiming it had based its determination on the medical records and results of the TSA. Curt appealed LINA’s decision noting in his appeal that he had been approved for Social Security Disability benefits and providing updated medical records and letters from his physicians.

Despite all the supporting medical documentation, LINA upheld its determination on both of Curt’s appeals. Curt sued LINA in a New York district court. The court, after reviewing LINA’s decision, found LINA’s termination of benefits was unreasonable and ordered LINA to reinstate Curt’s LTD benefits going forward as well as retroactively to the original date of termination.

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Our disability insurance lawyers help policy holders seeking short or long term disability insurance benefits from Lina. 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 Lina.

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Our lawyers help individuals that have either purchased a Lina 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 Lina:

  • ERISA and Non-ERISA Appeals of Disability Benefit Denials
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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.

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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, 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.

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