Our client, a successful New York dentist, was on claim for a number of years with Trustmark Insurance, due to severe orthopedic issues, which did not permit him to safely and effectively practice his profession.
His claim had originated with Continental Casualty Company, and then had been taken over for claim purposes by Trustmark insurance, a common occurrence. Trustmark Insurance administers a number of insurers and has purchased “blocks” of business of several insurers.
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In this matter, after many years of being on claim, Trustmark sought to investigate the claim as to whether our client had undergone the appropriate care and treatment for his orthopedic conditions. This is not an unusual practice for Trustmark, or other disability insurance companies.
His care was sporadic, as there were limited non-surgical options for him. It should be noted that Trustmark Insurance had previously accepted liability of this claim for a long period of time, following an examination that it required our client to undergo. This examination determined that our client was disabled, and unlikely to improve and would never able to return to full time work.
Many years later, trying to review this claim solely for purposes of harassment, Trustmark once again investigated the claim, hiring a doctor to conduct a paper-only review records, with no in-person medical examination.
We attacked Trustmark’s approach, using support from the initial physician review, and its more recent claim handling to effectively resolve our client’s dispute so that his future benefits will no longer be in jeopardy.
The outcome for our client has ensured future peace of mind for his claim, which is a lifetime benefit.
The key to the success in this claim was our working closely with the client to determine the results he sought to achieve while minimizing his financial outlay and mitigating his future risk of harm to the benefits. By addressing and rebutting the issues presented by Trustmark Insurance, we were able to develop a resolution platform from strength.Ready To Talk?
Jason Newfield is a founding partner of the disability insurance law firm Frankel & Newfield. He has spent the majority of his legal career advocating for the rights of disabled workers. He has lectured other professionals, worked on a Federal Advisory committee, and published many articles in the field of disability insurance claims and litigation.
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