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Podiatrist receives lump-sum buyout at pre-suit mediation with long-term disability insurer

Attorney Cesar GavidiaAuthor: Attorney Cesar Gavidia

The Client, a South Florida podiatrist, retained the law firm of Attorneys Dell & Schaefer in December 2007 due to the denial of disability benefits by one of her two long-term disability insurance carriers. Beginning in 1999 the client began suffering complications from fibromyalgia, sjogren’s syndrome, carpal tunnel syndrome and chronic fatigue syndrome.

Determined to continue the practice of podiatry and not allow her disabling conditions to destroy the practice she had worked so hard to build, the client continued to treat patients, perform surgeries and work a full time work week. However, it was not long before our client was forced to reduce her working hours and as a result experienced decreased revenues, less patients and canceled appointments.

Shortly thereafter, our client applied for residual / partial disability benefits with both of her long-term disability insurance carriers. The client initially was able to prove to the carriers’ satisfaction that she had suffered a loss of income as a result of her disabling conditions and was able to begin receiving disability benefits. For approximately two years, our client received partial disability benefits from her disability carriers and maintained her diminishing practice. Shortly thereafter, one of her insurers terminated her disability benefits contending that under their calculations her gross revenues did not reflect that she was experiencing the 20% loss of income necessary under the partial disability provision of the policy. Attorneys Gregory Dell and Cesar Gavidia discussed with the client the possibility of a pre-suit mediation with the insurance carrier to attempt to resolve the disagreement and avoid a lawsuit in Federal Court. If successful the process would save considerable time and costs for both parties. At mediation, Attorneys Dell and Gavidia presented our client’s position and were able to reach a confidential lump-sum buyout agreement of the disability policy.

Approximately one year after her case with one insurance carrier was settled, the second disability insurer communicated that they were interested in a lump sum buyout of the client’s partial disability claim. After several weeks of negotiation, Attorneys Gavidia and Dell were able to successfully negotiate a lump sum buyout for the client at 74% of the policy’s present value.



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