Frankel & Newfield recently won an ERISA appeal against Dearborn National on behalf of a patient whose illness transformed him from a creative man whose success was based on his brilliance and analytical abilities to one who struggles to maintain more than one thought at a time.
While his denial may have been the result of a clerical error at first, the fierce fight that we had to undertake to get him the disability benefits that he was entitled to is further proof to us of the heartlessness of disability insurance companies.
Our client was a CEO at an advertising and marketing agency suffering from Hypertrophic Cardiomyopathy. This is a cardiac condition, often genetic in nature where, in very simple terms, portions of the heart muscle become extremely thick. It is difficult for the heart to pump blood, forcing the heart to work harder. He underwent open heart surgery to remove part of the enlarged heart muscle, during which time he suffered a cerebral hypoxia. There was not enough oxygen getting to his brain, and the brain suffers damage that impairs the person’s ability to function. At worst, a hypoxic episode can cause death. At best, it leads to brain damage.
Our client no longer has the ability to think and act as he had before the surgery, and can no longer perform the functions and duties that are required from a CEO at a creative and fast-paced business. Dearborn National wanted to play a dating game with his future.
We proved that the insurance company had made an error by terminating our client’s coverage before his employment ended.
We took a highly aggressive approach, providing professional opinions of his treating doctors and numerous published peer-reviewed medical studies that confirmed that a substantial proportion of patients after cardiac surgery experience measurable impairment in their mental capabilities.
Our client was awarded the benefits that he was owed and is now being paid on claim.
Not everyone who undergoes open heart surgery is able to return to their previous life. For those individuals, disability insurance is supposed to be the lifeline that lets them and their families live with dignity and financial security. If your disability insurance company wants to cut off your lifeline, call us today to learn how we can help.