I learned of a story this week that really tugs at the heartstrings. A man in our area is fighting with his insurance company because they don't feel he is stressed enough. Mental maybe, but not stressed.
Let me go back to the beginning. The man, a family guy whose life was good; wife, children, job. Then they have a child who is not well and has to live at Toronto Sick Kids Hospital with mom at his side. That's bad. Dad is stressed.
He can't eat, he can't sleep, he can't concentrate at work. That in itself is a safety hazard cause his job entails concentration. So, the man's doctor does not think this man should be at work. His new child, is dependent on him and he needs to focus.
The doctor says this guy is a mess. The man needs to be there for his other children and he needs to be there for his wife. The doctor tells this man he is far too stressed to work and tells him get the insurance papers.
The man has been paying into this program for years and has never filed a claim. Now he needs the service. He brings the papers to the doctor, the doctor fills them out and the man sends them away. The insurance company declines the request. They want to know what drugs he is taking.
They want to know 20 pages of stuff. They suggest the man may need a psychiatrist. They could fulfill the wishes of the applicant if he could just be crazy.
The man does not want to be mentally ill, he just wants to help his family. Maybe he should see a psychiatrist to confirm his case. There are many people who think they are covered under all kinds of policies. That is until they try to collect.
David Share, a life insurance denial lawyer who specializes in these kinds of cases says he fights the insurance companies in such issues and usually wins. He says it is difficult to know what the "magic wording" is in this man's situation but at the end of the day, if a doctor states the man is stressed, that is almost always the final word. He said a legal solution is not immediate and will not alleviate the financial situation for the man, but it is a means to the end.
Medical evidence is solid, he says and that should not be disputed. Granted, the insurance company deals with fraud all the time. That is a given in today's society.
People try to stick it to the big guy. So, premiums go up and we all pay. But, in this case, the man has what seems to be a valid claim. Maybe the illness is not specifically to him, it is his dependent child who is sick.
That is likely what the insurance company is hanging its hat on. More and more employees who find themselves unable to work due to serious illness, accident or stress find that between their employer and group disability insurer, the race is on to show them the back of the hand, and the door. Please visit sharelawyers.
com for more information.
Jacob is a well known author who writes on the topics related to Bad faith Insurance Claim litigation & Disability Claims.