How We Can Help In Claims Against The Standard

The Standard sells both individual and group insurance policies for life insurance, accidental death and dismemberment insurance, short-term (STD) and long-term disability (LTD) insurance, personal income replacement insurance, dental insurance, vision insurance, and annuities.

The attorneys at Pillsbury & Coleman, LLP, defend the rights of California policyholders to obtain the benefits for which they have paid. We bring life, ADD, and disability claims appeals in ERISA and non-ERISA lawsuits against any insurer, including The Standard. Recently, Pillsbury & Coleman prevailed against The Standard and obtained disability benefits owed and attorney's fees in a published decision, Oster v. Standard Life Ins. Co., -- F.Supp.2d --, 2011 WL 31110 (N.D. Cal. 2011). See other successful results in ERISA cases.

In 2009, "Good Morning America" did a story on a disability claim denial that perfectly illustrates the problems that many policyholders experience when they try to bring a disability claim for benefits they've paid for under a long-term disability insurance policy. In this instance it was The Standard, but all insurers operate in a similar manner.

The subject of the story was a man with multiple sclerosis whose condition had worsened to the degree that he could no longer continue to work as an accountant. He filed for disability benefits and then began a waiting game, with the insurer asking for more and more information.

Finally, the policyholder secured a copy of his file from The Standard. In it he found a medical recommendation from a doctor he had never met who stated that the medical facts of his case did not support a diagnosis of MS. In this instance, the policyholder had been seen (in person) and diagnosed by 11 doctors, all of whom agreed he had MS. He was astounded that a doctor whom he had never seen could make such a statement and that The Standard would rely upon such a statement in the face of the medical evidence provided by his actual medical providers.

It's standard operating procedure for insurance companies such as The Standard to use in-house doctors and physician consultants to review medical files and to issue determinations without ever seeing a patient. While this certainly seems unfair to most people, it gets worse. Insurance policies are often written with a "discretionary clause" that allows the insurer to legally deny legitimate claims based on evidence provided by the insurer's in-house medical assessment.

If you have gotten the run-around from The Standard, or any other insurance company, there are things you can do to protect yourself. Policyholders do have rights. Call our San Francisco office at 415-655-1549 or send us an email to schedule a consultation.