ERISA Claims Against The Standard
San Francisco Lawyers Representing California and National Clients Against The Standard
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. Reach out to us at our San Francisco office at (415) 433-8000 or send us an email to schedule a consultation.