|By Gordon Gibb||Fresno, CA:|
A California woman whose life has been described as “a living hell” blames the insurance underwriter, in association with her former employer, for leaving her high and dry with
denied disability insurance for the past eight years. Injured on the job in 2003, she was only paid benefits for two years. In spite of substantial evidence as to the woman’s disability, the insurer stopped payments, resulting in job loss and homelessness.
Guadalupe Ortega even had her children taken away from her, according to The Fresno Bee (8/6/13).
Ortega’s denied ERISA disability story is heart-wrenching. The one-time employee of Lyons Magnus of Fresno was injured on the job about 10 years ago, suffering injuries to her shoulder, neck and back. Her employer acknowledged that Ortega’s injuries were work-related and occurred on the job. Doctors having examined Ortega concur that the woman is 70 percent disabled.
However, according to the report, Sedgwick Claims Management Services - the carrier tasked with undertaking disability insurance at Lyons Magnus - paid out disability checks to Ortega for two years, then abruptly stopped. The woman’s disability help, overnight, suddenly became a situation of long-term disability denied.
Changes to California Insurance Law in 2005 reduced penalties faced by insurance companies for not paying claims, including workers compensation claims, in a timely manner. Prior to the...