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Medical Doctor Suffering From Disabling Chronic Conditions Sues AXA Equitable For Wrongful Denial Of Disability Benefits

A Montana disability lawyer recently filed a federal lawsuit against the AXA Equitable Life Insurance Company (AXA). The Plaintiff, Marise J., M.D., was employed as a licensed medical doctor and was board certified in internal medicine. She had been practicing medicine for over 30 years.

In Marise J., M.D. v. AXA Equitable Life Insurance Company, Disability Management Services, Inc., and Does A-E, Inclusive, Plaintiff has filed this v to recover disability benefits that have been wrongfully withheld by AXA.

The Facts of the Case Against AXA

Plaintiff had a policy with AXA (formerly “The Equitable Life Assurance Society of the United States”) since October 4, 1987 that provided coverage for “Total Disability” and “Residual Disability.” The Plan provided up to $2,500 per month of coverage for Total Disability and a basic benefit for Residual Disability dependent upon the loss of Prior Monthly Earnings due to the inability to perform occupational duties.

On February 11, 2010, Plaintiff filed a claim for Residual Disability benefits due to the fact that she was suffering from disabling chronic conditions that impaired her ability to perform duties necessary to her practice. AXA notified Plaintiff on February 12, 2010 that her claim had been referred to DMS for continuing claim management and administration.

No Response From AXA Regarding Plaintiff’s Claim

Nineteen months have passed, but AXA still has not confirmed Plaintiff’s claim. Plaintiff continues to work reduced hours due to her disabling chronic conditions. She has been under the care of several physicians regarding her continuing condition. The failure of AXA to approve Plaintiff’s claim has led to much financial and emotional damage for the Plaintiff.

Disability Attorney Files Disability Lawsuit Against AXA

The lawsuit alleges that AXA failed to provide the following to the Plaintiff:

  • Residual Disability benefits as stated in the Policy;
  • Good faith and fair dealing in the adjustment and processing of her residual disability claim;
  • Fulfill the obligations to the Plaintiff that were stated in the Policy;
  • Authorizing the Residual Disability benefits that were stated in the Policy;
  • Adhering to Montana’s Unfair Trade Practices Act;
  • Acknowledging and acting reasonably promptly when it came to communications regarding the Plaintiff’s claim;
  • Not implementing reasonable standards for investigating the specific circumstances of the Plaintiff’s claim;
  • Not conducting a reasonable investigation before denying Plaintiff’s initial claim;
  • Not informing Plaintiff of approval or denial of benefits after Plaintiff timely filed her claim.

Plaintiff Seeks Following Relief From AXA

Due to AXA’s actions, Plaintiff wants the following relief by the Court:

  • A declaration that Plaintiff is entitled to all “Residual Disability” benefits;
  • A declaration that the date of residual disability for purposes of determining her “Prior Monthly Earnings” is December 2002;
  • A declaration that Plaintiff is to receive Residual Disability benefits for the rest of her life;
  • A declaration that Plaintiff is to be reimbursed for premiums after December 2002 when Plaintiff became residually disabled;
  • A declaration for AXA to pay all reasonable attorney fees and costs;
  • A declaration for AXA to pay for the mental anguish and emotional distress suffered by the Plaintiff;
  • A declaration that AXA pay for the damages caused to the Plaintiff;
  • A declaration that AXA pay for violations of Montana’s Unfair Trade Practices Act;
  • A declaration that AXA pay punitive damages to prevent AXA from committing similar actions in the future;
  • A declaration that AXA pay for all other relief that the Court declares to be just and proper.

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