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Physician Claims Insurance Company Unjustifiably Denied Long Term Disability

by | Dec 11, 2016 | Firm News

A San Francisco physician claims his insurance company wrongly denied long term disability benefits for his condition, the Norcal Record recently reported. Dr. Malcolm Smith suffers from depression. As a result, he filed a claim in the U.S. District Court for the Northern District of California on September 27th against Life Insurance Company Of North America. The claim states the company violated the federal employment act by not paying benefits owed to the insured individual.

Physician Claims Insurance Company Wrongly Denied Long Term Disability Benefits

The plaintiff stated he filed a disability claim in April 2013 for a psychiatric disability. Although his claim was approved by the defendant, the plaintiff was warned that his claim would end in April 2015 if he remained completely disabled because of the condition. As a result, he was advised in May 2015 that he is no longer eligible to receive disability benefits.

The plaintiff filed an appeal once his benefits were dropped. The appeal claims that his chronic and acute nerve damage is evidence of his disability and should qualify him to receive benefits. The claim states that Life Insurance Company Of North America failed to extend the plaintiff’s benefits, despite the evidence of his disability. Additionally, it failed to contact his physicians to learn about his condition. The plaintiff suffers from cervical radiculopathy and other post-operative disabilities, which the defendant failed to consider.

Dr. Smith is requesting a trial by jury to hear his case. He is seeking declaratory relief, interest, attorney’s fees, costs, and the reimbursement of expenses. His attorneys are seeking other forms of relief the court may deem justifiable.