Eric Cullin – Male, Franchise Owner
Eric was the father of four children. His oldest son had been accepted on a rowing scholarship to Yale and Eric was really excited about his son's future prospects. His son Eric Jr. attended Yale for his first semester in the fall of September, 2003. He had a great fall semester and was on his way home for the Christmas break, when tragedy struck.
While driving home he had a head-on collision with a drunk driver, suffering a massive head injury and was pronounced dead at the scene.
Eric and his family were in a state of shock. Initially, Eric Sr. continued to run his franchises and was working even harder to try and bury his grief, but within 6 months of his son's death, Eric Sr. had a nervous breakdown. He was in a deep depression and couldn't find the drive, energy or focus to carry on his business.
When those 3 months came and went, Eric was no better, and continued to see his family doctor and psychiatrist on a regular basis. The medication had been altered but to no avail.
In the meantime, the managers that Eric had in place continued to operate his franchises, however, 2 of the 5 locations had fairly junior managers and the absence of Eric started to be felt.
They could hold on a little longer, but they needed Eric to return or something was going to give.
Eric still showed no interest in his businesses and was having difficulty just maintaining his personal hygiene. The loss of his son took away his drive for living and now the insurance company removed any hope that he would recover from the depression to return to his business.
We told Eric and his family disability claims based on depression or mental disorders were difficult because they were largely based on subjective complaints and symptoms that were hard to prove. Clearly, the cause of Eric's depression was easy to see, and Canada Life even initially accepted the claim.
Pursuing the Claim
In addition, further medical reports were sought and obtained, with treatment plans that were designed to provide a clear picture of how Eric might overcome his depression given time and extensive counseling.
Defending the Claim
They found some former disgruntled manager, who was no longer employed by Eric, who was prepared to say that Eric always talked about early retirement, and that he wasn't going to run these shops forever.
With the help of an experienced mediator, and after many contentious hours, a settlement was reached that paid Eric the back payments he was owed and also provided for a lump sum for future benefits for a reasonable period of time that both sides could agree to. This would give Eric the freedom to overcome his tragedy without the insurance company constantly looking over his shoulder.
The policy continued to be available for future claims outside the periods for which benefits were paid, should Eric suffer other disabling conditions.
With the settlement in hand, Eric was able to start seeing some light at the end of the tunnel. He began to realize that nothing could bring Eric Jr. back but he still had a lot to live for with his remaining family.