Prior to his biopsy, a patient confessed to the nurse just how nervous he was. “Don’t worry,” the nurse assured him. “You’re just having a little autopsy.”
IN PERSON: Anthony Caproni (continued from page 1)
Anthony informed her that he was currently seeing a physical therapist and was not sure if he was going to have the surgery he and his doctor had discussed. A week after this telephone conversation, Anthony received a letter stating that his benefits had been terminated. The reason cited in the letter was “non-compliance” with recommended treatment.
Benefits Terminated and Appeals Denied
Anthony and his doctor were taken aback by this; they assumed that the insurance company had misconstrued his clinical notes and records. Together, they submitted an appeal. When that was also denied, Anthony knew he was in trouble. Anthony’s neighbours, who had had their own troubles with their insurance company in the past, recommended he contact Share Lawyers for a free consultation.
Legal Action Taken
Anthony met with Share Lawyers and was assured that it wasn’t the end of the road for his claim. After a thorough assessment, he was provided with a clear explanation of what to expect after suing the insurance company for benefits.
It was a great relief to know that, while legal action was not an overnight resolution; the firm would handle every step of the process so that he no longer had to battle with the insurance company. He could finally focus on getting better while his lawyers focused on winning him the maximum settlement possible.
Working Toward a Settlement
After reviewing Anthony’s policy and medical history with a fine-tooth comb, Share Lawyers prepared their case against the insurance company.
In mediation, Share Lawyers used expert medical evidence to identify that Anthony had fully complied with all recommended treatments at different points in his disability. The insurance company argued that Anthony should have opted for surgery as soon as he could not continue working; however, Share Lawyers demonstrated that in Anthony’s case, surgery was recommended as a last resort, and that he was pursuing other less invasive options when he was terminated from his benefits. The case was settled after many hours of aggressive negotiations between Share Lawyers and the insurance company’s legal counsel. Anthony was finally awarded a sizeable lump-sum to cover disability benefits owed, a portion of benefits he would have received in the future, as well as a portion of his legal expenses.
After the Settlement
Anthony was pleased with the outcome of his case because it afforded him the time to make the best choice for his health. Ultimately, he did require carpal tunnel release surgery, and he was able to return to work a few months later on a modified basis.SP
[Names and identifying details have been changed to protect the confidentiality of all involved.]