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Ortiz Law Firm | National Disability Law Firm
Ortiz Law Firm is dedicated to helping people recover the disability benefits they deserve. We handle group Long Term Disability (LTD) claims, individual disability insurance policy claims, ERISA disability claims, and Social Security Disability claims.
Krueger filed for long-term disability benefits after developing POTS. Reliance Standard denied her claim, arguing it was a pre-existing condition based on earlier treatments for migraines and tachycardia. The court disagreed, finding Krueger’s symptoms and diagnosis were distinct and not properly excluded under the policy. It ruled in her favor …
Dr. April Halleron, a Kentucky physician, filed for STD and LTD benefits due to disabling symptoms from POTS. Reliance Standard denied both claims, citing a pre-existing condition exclusion for STD and lack of evidence for LTD. The court found both denials procedurally flawed and arbitrary, especially for failing to consider her treating …
When shopping for or reviewing disability insurance, one important clause to understand is the “pre-existing condition exclusion.” This clause can significantly impact your ability to collect benefits if your disability is related to a medical condition you had before your coverage began. But here’s the key distinction: while …
In Easter v. Hartford Life & Accident Ins. Co., the plaintiff, Audrey M. Easter, a former Social Worker for Intermountain Healthcare, was insured under a disability insurance plan administered by Hartford. Under this plan, Defendant Hartford was the claims administrator responsible for determining benefits and the payor of those claims. ERISA …
Recently, we appealed a claim denial issued by The Standard. The claim had been denied because the insurance carrier had determined that the claimant’s condition was caused or contributed to by a pre-existing condition. This is not an unusual basis for a long-term disability claim denial. However, upon further review, we determined this …
Ms. Harrison was a claimant who worked as a customer service representative for a cash advance lender. Her duties included selling financial products to customers, providing customer service, handling money, and overseeing financial transactions. She also suffered from depression and anxiety during her time at this place of …
If your long-term disability (LTD) insurance claim was denied due to a “pre-existing condition,” know that you’re not alone. Many claimants are in the same situation, often without a clear understanding of what the term means or how it applies to their case. This article will explain the concept of pre-existing condition exclusions in LTD …
Okuno has not established that she satisfied the requisite conditions to obtain disability benefits beyond what Reliance has already paid. Reliance's denial of continued long-term disability benefits appears to have been the result of a principled and deliberative reasoning process. Accordingly, Reliance is entitled to judgment on the …
Marcia L. Smith (“Smith”) worked as a property manager for Arlington Properties, Inc., and starting on March 1, 2016, she was covered under a long-term disability plan administered by United of Omaha Life Insurance Company and Mutual of Omaha Insurance Company (collectively, “United”). The plan provided the following as part …
The fact that Dee was eventually diagnosed with cancer and that her shoulder pain “in retrospect” was caused by her cancer is not material to a determination of whether her medical care providers at the time of the medical treatment suspected cancer.
In the instant case, Julissa Bradshaw (“Bradshaw”) was a medical biller for Pyramid Healthcare Solutions, Inc. (“Pyramid”). She held a policy through Reliance Standard Life Insurance Company (“Reliance Standard”) for both short-term and long-term disability coverage. Her coverage under this policy began on May 1, 2013. When Bradshaw was hired by …