Michail Hack, Partner
Our client, a brilliant financier and dealmaker, underwent brain surgery to repair a significant neurological issue. Though the procedure was successful, it left our client unable to perform the high-level cognitive and analytical duties that the profession demanded. Despite the injuries, our client was resolute to lead a productive life. Our client transitioned to a more manageable role in a different, yet parallel, industry – but one that was considerably less lucrative.
The Challenge
For years, our client’s long-term disability insurance company paid partial disability benefits under a “reservation of rights.” In this common insurance industry practice, insurers provisionally pay benefits but do not yet accept liability – and thus reserve the right to later deny the claim if they find supporting evidence. Over time, the insurance company’s scrutiny of our client’s case intensified, with repeated demands for proof of loss, surveillance efforts, and a request for an Independent Medical Examination (IME).
The Solution
In response to the insurer’s increased scrutiny, Schwartz Conroy & Hack partner Michail Hack and his team compiled comprehensive evidence to bolster our client’s claim. We prepared detailed occupational descriptions for both positions, clearly illustrating the differences in scope and cognitive demand between the two roles. We had our client submit to a comprehensive, day-long, neuropsychological evaluation, a test to gauge the brain’s current processing power. We gathered testimonials from people close to our client to speak to the difference in our client’s abilities pre- and post-disability. To further strengthen the claim, we obtained and reviewed the client’s actual imaging studies, identifying and isolating the scans that showed where the neurological anomalies had been located. This visual evidence told the story more powerfully than words.
We submitted a comprehensive package of letters, occupational analyses, neuropsychological findings, and imaging visuals to demonstrate the legitimacy and persistence of our client’s disability.
The Result
When faced with overwhelming, irrefutable evidence of our client’s disability, the insurance company ultimately withdrew its reservation of rights and admitted liability.
If you have any questions regarding a current or potential long-term disability claim, please do not hesitate to contact Schwartz, Conroy and Hack, PC. We have the expertise and tenacity to make insurance companies keep the promises they make to policyholders like you.
