Many injured or disabled workers fear that a denial of insurance coverage or disability benefits marks the end of an already-frustrating road of red tape and dead ends. But that’s precisely when CMM was retained to turn a client’s difficult journey around.
A Fortune 500 insurance company had denied coverage for long-term disability benefits to our client, insisting that he “did not meet the policy definition of Disability” despite well-documented medical records to the contrary. CMM fought back. Christine Malafi appealed the finding, arguing that our client’s medical records and physician assessments provided well-documented and overwhelming evidence of significant impairment such that our client was wholly unable to work.
CMM further argued that the insurance company’s denial was egregious as it was based entirely on the opinion of their own medical assessor, which was not only a clear conflict of interest but also entirely unsupported by the record. The appeal affirmed that our client was legally entitled to coverage in light of his fully-disabled status as confirmed by the Social Security Administration.
In a major win, CMM’s appeal was so persuasive that the insurance company reversed its own decision within weeks. As anyone who has attempted to obtain disability or insurance benefits knows, such a turnaround time is extraordinary. Our client can now collect benefits, stay in his home, and have financial stability during a difficult medical crisis.