We recently learned that Standard Insurance Company has agreed with the position we took on behalf of a client whose claim for long-term disability benefits had been denied. Our client’s claim was somewhat unique in that she had been receiving long-term disability benefits for several years due to her chronic cardiac condition and related medical issues including a diagnosis of bi-polar disorder. Hoping that she had regained some stamina and because she was frustrated with living too simplified of a life, basically staying at home, our client wanted to attempt a return to employment. Wisely, before doing so, she spoke with the claims representative at Standard Insurance who ensured her that she had a 180-day window within which to attempt to return to work and that if she was unable to do so, her disability benefits would recommence, a.k.a a recurrent disability claim. Relying on this representation our client returned to work for a couple of months and quickly realized her medical condition did not allow her to do so. In contacting her claims representative after the return-to-work failed, she was shocked to learn that the reinstatement of disability benefits would not occur, because she had not returned to her former employer for the trial return to work period.
In presenting an internal appeal to Standard Insurance on behalf of the client, we asserted that Standard Insurance had breached its fiduciary duty to our client and that the legal theories of waiver and promissary estoppel prevented Standard from refusing to reinstate benefits, as our client had relied upon the previous misrepresentations. Ultimately, and perhaps because Standard Insurance did not want to litigate this matter in court, the insurance company took the correct action and decided to reinstate the disability benefits.
The appeal to Standard Insurance was prepared by attorney Heather Petitmermet and legal assistant MarySue Kern. Our office handles a wide variety of insurance denial claims. The majority of this work is in the arena of disability income replacement and life insurance benefits. If you are a resident of Colorado, or any state for that matter, and would like to have your denied claim reviewed by a disability insurance lawyer at the Law Office of Shawn E. McDermott, feel free to contact us by clicking here, and completing our contact form of by calling (303) 964-1800.