Gastrointestinal Surgery Leads to a Fight With the Insurance Company

Gastrointestinal Surgery Leads to a Fight With the Insurance Company

45-year-old Jade was a nurse in the emergency department of a major hospital in North York. She had been at the same hospital for almost ten years, and loved every bit of her job. Understandably, things at work were stressful – the hours were irregular and she was constantly on her feet, but her positive attitude had never wavered.

Jade had struggled with weight gain and overeating for a majority of her life. Lately, she had been experiencing intense regular stomach aches and heartburn. In 2009, she sought advice from her physician, as well as her connections within the medical community – she had been working with various specialists during her career. She got the advice she needed quickly. Jade’s physician advised her to consider having a gastrointestinal surgery, and with Jade’s connections, she was able to plan and book her surgery quickly. As a nurse, she understood that her health should be her top priority.

The surgery went well. However, almost a year later, Jade began to experience some disturbing side effects. One day she felt nauseous at work and had to excuse herself and take a cab home. Two days later, she fell sick two hours into the work day, and again had to go home sick. The following week was followed by even more frequent occurrences of intense nausea. Deciding that this was now more than a random series of events, Jade decided to see her physician again. After running some tests, her physician prescribed her some medicine to help with the nausea. She would have to schedule a consultation with her physician at least four times a year, but at least the nausea would be manageable and she could continue working. This was the case for the next couple of years.

Jade didn’t want to admit it but she had to make a decision between her health and work.

Last year Jade’s condition worsened. Her symptoms were now impacting her work, personal and social life. She was experiencing more frequent episodes of chronic vomiting and even putting on weight again as a result of all the stress. Multiple times a day she would have to excuse herself from work to vomit. She was also sleep deprived, as the episodes occurred all throughout the night. With all of this happening, situational depression hit hard. Jade didn’t want to admit it but she had to make a decision between her health and work. She finally understood the severity of her condition, and ultimately decided that it was time to stop working. Her family, friends and colleagues supported her all the way.

She gathered the necessary documents and made her claim for long-term disability benefits. Jade was in complete disbelief when her claim was denied. She had never missed a payment especially since her surgery in 2009 – she always anticipated her situation even though she dreaded it. After multiple back-and-forths, the insurance company stated that her claim was denied because the surgery had been back in 2009 and she had worked for multiple years after that.

Jade was unwilling to accept this answer, and while doing some research happened to come across a Share Lawyers blog post about long-term disability claims. After a consultation meeting, the Share Lawyers team immediately got to work on her case to get the insurance company to approve the claim.

A settlement was reached and Jade, with the help of Share Lawyers, was able to win her case. She felt that she had been bullied by the insurance company and so was very happy with the understanding and care she received at Share Lawyers. Now she could focus on her health, knowing that her benefits would support her while she recovered.

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