One day, she felt a lump in her breast. After medical testing,she was diagnosed with breast cancer. At first she was able to go on with her life, while she tried conservative treatment. Unfortunately, the treatment failed and she had to have a masectomy. The other doctors in her practice group decided to hire a replacement until she was better. Margarite's oncologist said it would take between 3-6 months to recover from her surgery, so Margarite applied for disability benefits under her private policy.
There was a 30 day waiting period after which her insurance started to pay her benefits. The surgery was successful, but the doctors found another lump and she needed to go for another round of chemotherapy. Psychologically, Margarite was a mess and physically she was so exhausted all the time. Her oncologist suggested taking more time off.
Margarite wanted to try to return to work, so she phoned her insurance company to see if she could attempt to return to work part-time. They had been paying her benefits for about 6 months at this time. They encouraged her to try to return to work and when she did they cut off her benefits.
She was only able to work part-time 3 mornings a week and counted on the top-up provision which her insurance was supposed to pay in the event of a partial disability. She provided details of her earnings, which showed that she was only working part-time, but the insurance company took the position that she was capable of full-time work, relying upon the oncologists original prognosis of 6 months of total disability.
Margarite appealed this decision twice, submitting more medical information and evidence of financial loss. The insurance company continued to reject her claim.
Margarite had to put her house up for sale because she had very little income. She just did not have the stamina to work more than three mornings per week. Margarite saw an ad on TV a few months earlier and had written down the website. She read it thoroughly and then phoned Share Lawyers. She hired Share Lawyers to pursue her rights against the insurance company. After extensive legal proceedings and obtaining additional expert evidence from doctors and forensic accountants, Share Lawyers was able to negotiate a settlement for Margarite.
The settlement included a lump sum for amounts owing to Margarite for benefits that should have been paid in the amount of $84,000.00; another $130,000.00 for partial disability benefits for the next 3 years, and she was able to keep the policy in the event of a subsequent disability.